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General NPI Number Information
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NPI Number | 1003543240
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Entity Type | Organization
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Legal Business Name | IV HARMONY CLINIC LLC
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Dates
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Enumeration Date | 08/08/2022
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 2749 E COUNTY LINE RD
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City | LUTZ
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State | FL
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Zip | 33559
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Country | US
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Telephone | 813-325-3870
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 615
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City | SAN ANTONIO
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State | FL
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Zip | 33576-0615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | GABRIEL VARGAS
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Credential |
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Telephone | 787-598-9839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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