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General NPI Number Information
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NPI Number | 1275909657
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Entity Type | Organization
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Legal Business Name | MIAMI CENTER FOR ORIENTAL MEDICINE
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/06/2016
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Provider Practice Location Address
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Address Line | 700 SW 57TH AVE
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City | MIAMI
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State | FL
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Zip | 33144-3922
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Country | US
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Telephone | 305-265-5265
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Fax |
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Provider Business Mailing Address
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Address Line | 1317 OBISPO AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-3511
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Country | US
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Telephone | 305-265-5265
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EVA PAGLIALONGA
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Credential | DAOM, L.AC.
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Telephone | 305-265-5265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | AP2389
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License Number State | FL
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