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General NPI Number Information
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NPI Number | 1972597193
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Entity Type | Individual
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Provider Name | VIOLA MAF JACOB MD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 1451 HAVEN DR
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City | OVIEDO
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State | FL
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Zip | 32765-5286
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Country | US
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Telephone | 407-215-4999
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Fax | 352-394-5992
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Provider Business Mailing Address
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Address Line | PO BOX 121176
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City | CLERMONT
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State | FL
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Zip | 34712-1176
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Country | US
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Telephone | 407-215-4999
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Fax | 888-762-3102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME90116
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME90116
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License Number State | FL
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