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General NPI Number Information
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NPI Number | 1083802870
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Entity Type | Organization
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Legal Business Name | WEST DIAGNOSTIC MEDICAL IMAGING INC
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 2170 W 68TH ST
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City | HIALEAH
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State | FL
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Zip | 33016-1876
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Country | US
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Telephone | 186-659-5529
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Fax | 954-636-5428
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Provider Business Mailing Address
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Address Line | 6700 N ANDREWS AVE 109
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-2165
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Country | US
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Telephone | 954-636-3406
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Fax | 954-636-5428
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SOLANGIE MACHADO
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Credential |
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Telephone | 954-636-3406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | FL
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