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General NPI Number Information
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NPI Number | 1053390732
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Entity Type | Individual
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Provider Name | LUIS J ORTIZ-ESPINOSA M.D., FAAD
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Gender | Male
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | PQ-28 AVE. EL COMANDANTE COUNTRY CLUB
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-752-3280
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Fax | 787-752-8920
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Provider Business Mailing Address
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Address Line | 90 AVE. RIO HONDO PMB 126
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-706-1006
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Fax | 787-269-2822
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 9468
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License Number State | PR
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