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General NPI Number Information
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NPI Number | 1053485391
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Entity Type | Organization
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Legal Business Name | ANA LUISA T-Y SAFRA MD, LLC
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 13005 SOUTHERN BLVD SUITE 225
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-9206
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Country | US
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Telephone | 561-313-4884
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Fax | 561-784-7202
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Provider Business Mailing Address
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Address Line | PO BOX 211237
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33421-1237
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Country | US
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Telephone | 561-313-4884
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Fax | 561-784-7202
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANA L SAFRA
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Credential | MD
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Telephone | 561-313-4884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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