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General NPI Number Information
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NPI Number | 1114104569
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Entity Type | Organization
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Legal Business Name | CENTRO DE VACUNACION DEL OESTE
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | CARRETERA 107 VICTORIA
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City | ANASCO
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State | PR
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Zip | 00610-0740
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Country | US
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Telephone | 787-313-4242
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Fax | 787-826-9700
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Provider Business Mailing Address
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Address Line | PO BOX 740
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City | ANASCO
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State | PR
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Zip | 00610-0740
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Country | US
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Telephone | 787-313-4242
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Fax | 787-826-9700
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Authorized Official
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Title or Position | PRESIDENTA-ADMINISTRADORA
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Name | MRS. ELIZABETH SOTO LORENZO
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Credential |
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Telephone | 787-313-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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