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General NPI Number Information
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NPI Number | 1003712183
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Entity Type | Individual
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Provider Name | CRICIRE IVAN FLORES AGUDA
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Gender | Male
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Dates
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Enumeration Date | 10/16/2026
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Last Update Date | 10/16/2026
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Provider Practice Location Address
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Address Line | 1320 S ORLANDO AVE UNIT 3
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City | WINTER PARK
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State | FL
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Zip | 32789-5556
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Country | US
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Telephone | 407-504-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 4113 SCARLET BRANCH RD
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City | ORLANDO
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State | FL
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Zip | 32824-5087
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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 |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT44086
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License Number State | FL
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