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General NPI Number Information
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NPI Number | 1184634818
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Entity Type | Organization
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Legal Business Name | BUENA VISTA MEDICAL SERVICES INC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 11805 SW 46TH ST
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City | MIAMI
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State | FL
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Zip | 33175-4739
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Country | US
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Telephone | 305-610-2526
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Fax | 305-221-5224
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Provider Business Mailing Address
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Address Line | 11805 SW 46TH ST
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City | MIAMI
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State | FL
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Zip | 33175-4739
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Country | US
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Telephone | 305-610-2526
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Fax | 305-221-5224
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. CARLOS A PEREZ
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Credential | M.D.
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Telephone | 305-610-2526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | FL
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