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General NPI Number Information
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NPI Number | 1972278042
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Entity Type | Organization
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Legal Business Name | JOSEPH F CONDON, MD INC
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 3417 TAMIAMI TRL STE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8158
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Country | US
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Telephone | 978-440-0380
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Fax | 877-349-5062
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Provider Business Mailing Address
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Address Line | 3417 TAMIAMI TRL STE A
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8158
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Country | US
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Telephone | 978-440-0380
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Fax | 877-349-5062
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH F CONDON
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Credential |
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Telephone | 941-626-5291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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