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General NPI Number Information
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NPI Number | 1073177523
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Entity Type | Organization
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Legal Business Name | HECTOR I PALLAVICINI MD PA
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 3499 W 4TH AVE STE 201
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City | HIALEAH
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State | FL
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Zip | 33012-4333
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Country | US
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Telephone | 305-558-0411
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Fax | 305-863-3802
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Provider Business Mailing Address
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Address Line | 3499 W 4TH AVE STE 201
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City | HIALEAH
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State | FL
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Zip | 33012-4333
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Country | US
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Telephone | 305-558-0411
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Fax | 305-863-3802
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Authorized Official
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Title or Position | OWNER
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Name | DR. HECTOR PALLAVICINI
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Credential | MD
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Telephone | 305-558-0411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086H0002X
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Taxonomy Name | Hospice and Palliative Medicine (Surgery) Physician
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License Number |
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License Number State |
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