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General NPI Number Information
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NPI Number | 1063621787
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Entity Type | Organization
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Legal Business Name | EXCEL MEDICAL DIAGNOSTICS INC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 10000 SW 56TH ST STE 29 SUITE 29
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City | MIAMI
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State | FL
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Zip | 33165-7163
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Country | US
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Telephone | 305-455-7711
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Fax | 305-455-7713
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Provider Business Mailing Address
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Address Line | 10000 SW 56TH ST STE 29 SUITE 29
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City | MIAMI
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State | FL
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Zip | 33165-7163
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Country | US
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Telephone | 305-455-7711
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Fax | 305-455-7713
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Authorized Official
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Title or Position | OWNER
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Name | MR. AMADOR DIAZ
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Credential |
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Telephone | 305-455-7711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | HCC4640
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License Number State | FL
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