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General NPI Number Information
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NPI Number | 1073223921
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Entity Type | Organization
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Legal Business Name | RENEW VEIN CENTERS, PLLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/01/2022
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Provider Practice Location Address
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Address Line | 2500 E HALLANDALE BEACH BLVD STE 406
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4837
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Country | US
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Telephone | 917-699-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 509 MADISON AVE RM 1111
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City | NEW YORK
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State | NY
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Zip | 10022-5549
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL AZIZ
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Credential | M.D
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Telephone | 917-699-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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