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General NPI Number Information
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NPI Number | 1124385778
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Entity Type | Organization
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Legal Business Name | MAURO RODRIGUEZ, M.D.
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 611 DRUID RD E STE 506
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City | CLEARWATER
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State | FL
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Zip | 33756-3938
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Country | US
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Telephone | 727-600-8090
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Fax | 727-600-8088
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Provider Business Mailing Address
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Address Line | 611 DRUID RD E STE 506
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City | CLEARWATER
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State | FL
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Zip | 33756-3938
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Country | US
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Telephone | 727-600-8090
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Fax | 727-600-8088
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. MAURO RODRIGUEZ
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Credential | M.D.
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Telephone | 727-600-8090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME0024891
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License Number State | FL
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