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General NPI Number Information
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NPI Number | 1063671923
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Entity Type | Organization
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Legal Business Name | GRUPOMEDICOMORENOALVAREZLOPEZ
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | CALLE MARIO BRASCHI 18
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-825-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CALLE MARIO BRASCHI
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City | COAMO
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State | PR
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Zip | 00769-2526
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Country | US
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Telephone | 787-825-1020
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Fax |
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Authorized Official
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Title or Position | ADMINISTRADOR
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Name | MRS. MARIA APONTE
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Credential |
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Telephone | 787-825-1020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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