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NPI 1265394977

NPI 1265394977 : FELIPE BUENO QUIRINO : GLENDALE, AZ

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General NPI Number Information
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    NPI Number           |    1265394977
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    Entity Type          |    Individual 
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    Provider Name        |    FELIPE BUENO QUIRINO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/01/2025
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    Last Update Date     |    12/03/2025
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Provider Practice Location Address
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    Address Line         |    17235 N 75TH AVE STE F100 
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    City                 |    GLENDALE
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    State                |    AZ
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    Zip                  |    85308-0871
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    Country              |    US
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    Telephone            |    480-878-7115
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    17235 N 75TH AVE STE F100 
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    City                 |    GLENDALE
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    State                |    AZ
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    Zip                  |    85308-0871
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    Country              |    US
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    Telephone            |    480-878-7115
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    AZ
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