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General NPI Number Information
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NPI Number | 1205287927
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Entity Type | Individual
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Provider Name | IGHEL JAVIER VEGUE D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 2808 SW 23RD ST
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City | MIAMI
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State | FL
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Zip | 33145-3310
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Country | US
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Telephone | 205-499-6481
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Fax |
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Provider Business Mailing Address
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Address Line | 5040 NW 7TH ST STE 635
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City | MIAMI
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State | FL
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Zip | 33126-3796
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Country | US
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Telephone | 205-499-6481
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS15819
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License Number State | FL
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