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General NPI Number Information
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NPI Number | 1073711479
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Entity Type | Individual
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Provider Name | JUAN CARLOS MALDONADO-MELENDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 07/21/2017
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Provider Practice Location Address
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Address Line | 49B CALLE MORELL CAMPOS
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City | ARECIBO
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State | PR
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Zip | 00612-4318
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Country | US
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Telephone | 787-878-2758
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Fax | 787-817-3531
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Provider Business Mailing Address
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Address Line | 512 CAMINO DE RIO ABAJO
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City | DORADO
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State | PR
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Zip | 00646-3644
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Country | US
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Telephone | 787-880-7200
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Fax | 787-881-6072
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 17209
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 62251
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License Number State | GA
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