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General NPI Number Information
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NPI Number | 1154391415
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Entity Type | Organization
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Legal Business Name | MUNICIPALITY OF SAN JUAN PR
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | CENTRO MEDICO BO. MONACILLOS
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-766-2222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 21405
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City | SAN JUAN
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State | PR
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Zip | 00928-1405
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Country | US
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Telephone | 787-480-3876
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Fax |
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Authorized Official
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Title or Position | CEO/ EXECUTIVE DIRECTOR
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Name | DR. LUIS V CLAS
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Credential | MD
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Telephone | 787-480-3838
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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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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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