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General NPI Number Information
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NPI Number | 1194099101
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Entity Type | Organization
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Legal Business Name | GUILLERMO D VARONA MD
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | N88W16624 APPLETON AVE
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2858
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Country | US
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Telephone | 262-251-9260
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Fax | 262-251-5844
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Provider Business Mailing Address
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Address Line | N88W16624 APPLETON AVE
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2858
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Country | US
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Telephone | 262-251-9260
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Fax | 262-251-5844
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. GUILLERMO D VARONA
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Credential | M
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Telephone | 262-251-9260
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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 | 20708
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License Number State | WI
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