ProviderBusinessMailingAddressFaxNumber = '8134053938'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1225681398
BASTILLE
ADAM
7814 N DALE MABRY HWY
TAMPA
FL
336143220
1164880308
COLLAZO EIJO
YORDENYS
7814 N DALE MABRY HWY
TAMPA
FL
336143220
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