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General NPI Number Information
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NPI Number | 1992817548
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Entity Type | Individual
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Provider Name | MARLA VIONETTE VILLAR MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 1100 CESERY BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32211-5674
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Country | US
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Telephone | 904-551-5884
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Fax | 904-562-3384
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Provider Business Mailing Address
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Address Line | 12171 SW 268TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-8001
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Country | US
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Telephone | 305-278-0200
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN900
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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 | 013678
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License Number State | PR
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