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General NPI Number Information
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NPI Number | 1083631766
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Entity Type | Organization
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Legal Business Name | DYNASTY CARE MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 5840 SW 8TH ST SUITE 2
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City | WEST MIAMI
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State | FL
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Zip | 33144-5051
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Country | US
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Telephone | 305-266-7673
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Fax | 305-266-7675
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Provider Business Mailing Address
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Address Line | 5840 SW 8TH ST SUITE 2
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City | WEST MIAMI
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State | FL
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Zip | 33144-5051
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Country | US
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Telephone | 305-266-7673
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Fax | 305-266-7675
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD TORRES
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Credential |
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Telephone | 305-266-7673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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