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General NPI Number Information
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NPI Number | 1194092312
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Entity Type | Individual
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Provider Name | CAROLINA LOIZA MM
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Gender | Female
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 3501 HEALTH CENTER BLVD
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City | BONITA SPRINGS
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State | FL
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Zip | 34135
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Country | US
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Telephone | 239-949-9000
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Fax | 239-949-9020
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Provider Business Mailing Address
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Address Line | 6725 CEDAR RIDGE DR
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542
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Country | US
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Telephone | 813-788-7662
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Fax | 813-788-7464
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MM25983
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License Number State | FL
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