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Individual

V JOHN DSOUZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD SC

Contact information

Practice address
576 STERTHAUS AVE, SUITE A, ORMOND BEACH, FL 32174-5128
(386) 677-7260
(386) 672-6194
Mailing address
PO BOX 741240, ORANGE CITY, FL 32774-1240
(386) 774-5211
(386) 774-5251

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME55087
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
064866300
FL
01
290005709
RRMC
01
P00277876
RAILROAD MEDICARE
Enumeration date
03/07/2006
Last updated
02/01/2012
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