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General NPI Number Information
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NPI Number | 1023433281
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Entity Type | Organization
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Legal Business Name | IGENOMIX USA LLC
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 7955 NW 12TH ST STE 415
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City | DORAL
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State | FL
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Zip | 33126-1823
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Country | US
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Telephone | 305-501-4948
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Fax | 786-401-7546
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Provider Business Mailing Address
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Address Line | 7955 NW 12TH ST STE 415
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City | DORAL
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State | FL
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Zip | 33126-1823
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Country | US
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Telephone | 305-501-4948
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Fax | 786-401-7546
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Authorized Official
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Title or Position | REGIONAL ACCOUNT MANAGER
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Name | ARTESIA JACKSON
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Credential |
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Telephone | 888-959-3968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 800027055
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License Number State | FL
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