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General NPI Number Information
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NPI Number | 1972794857
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Entity Type | Organization
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Legal Business Name | JUAN CARLOS GIACHINO MD, PA
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 421 SE OSCEOLA ST
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City | STUART
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State | FL
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Zip | 34994-2505
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Country | US
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Telephone | 772-283-8160
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Fax | 772-283-8177
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Provider Business Mailing Address
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Address Line | 1801 SE HILLMOOR DR STE A-107
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7545
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Country | US
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Telephone | 772-283-8160
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Fax | 772-283-8177
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUAN C GIACHINO SR.
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Credential | MD
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Telephone | 772-283-8160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME86071
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0032724
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License Number State | FL
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