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1609611730
JOHN BACON
TAMPA, FL
NPI
1609611730
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11032861)
Enumeration Date
2024-06-29
Last Update Date
2024-08-22
Business Address
JOHN BACON
3010 E 138TH AVE STE 12
TAMPA, FL 33613-3999
Phone number: 813-975-2800
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Mailing Address
JOHN BACON
31033 EDENDALE DR
WESLEY CHAPEL, FL 33543-6888
Phone number: 813-442-2248
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