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General NPI Number Information
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NPI Number | 1003094855
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Entity Type | Individual
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Provider Name | LILIA DIAZ PINO PH.D., ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 2703 N PONCE DE LEON BLVD
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City | ST AUGUSTINE
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State | FL
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Zip | 32084-2603
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 SW 100TH ST
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City | MIAMI
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State | FL
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Zip | 33156-2523
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Country | US
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Telephone | 786-255-0763
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9182489
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License Number State | FL
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