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General NPI Number Information
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NPI Number | 1144870510
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Entity Type | Individual
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Provider Name | ILEANEXCIS SANTINI-SOTO
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Gender | Female
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 08/04/2024
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Provider Practice Location Address
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Address Line | 29516 KOHOUTEK WAY
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City | UNION CITY
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State | CA
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Zip | 94587-1221
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Country | US
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Telephone | 510-441-8240
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Fax |
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Provider Business Mailing Address
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Address Line | 2707 BREEZY LAKE LN UNIT 105
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City | LAND O LAKES
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State | FL
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Zip | 34638-3796
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Country | US
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Telephone | 787-430-6788
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 20804
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 28834
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License Number State | CA
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