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General NPI Number Information
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NPI Number | 1245075936
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Entity Type | Organization
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Legal Business Name | AV MEDICAL CENTER INC.
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Dates
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Enumeration Date | 06/26/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 1301 N LAWNWOOD CIR
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City | FORT PIERCE
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State | FL
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Zip | 34950-4825
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Country | US
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Telephone | 772-577-6232
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Fax | 305-402-0941
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Provider Business Mailing Address
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Address Line | 3357 SW FRANKFORD ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-4938
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Country | US
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Telephone | 786-547-2767
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Fax | 305-402-0941
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Authorized Official
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Title or Position | OWNER
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Name | MR. WALSIN ROMERO
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Credential |
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Telephone | 786-547-2767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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