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General NPI Number Information
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NPI Number | 1033700877
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Entity Type | Individual
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Provider Name | LISANDRA SANTOS DEL CASTILLO FNP
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Gender | Female
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-6743
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Fax | 786-533-9711
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Provider Business Mailing Address
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Address Line | PO BOX 198054
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City | ATLANTA
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State | GA
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Zip | 30384-8054
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Country | US
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Telephone | 786-596-6743
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11011411
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11011411
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11011411
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License Number State | FL
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