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General NPI Number Information
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NPI Number | 1285016352
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Entity Type | Individual
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Provider Name | GUSTAVO ARIEL LUCIANI R.T.T.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 6200 SW 73RD ST
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4679
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Country | US
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Telephone | 786-238-2151
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Fax |
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Provider Business Mailing Address
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Address Line | 15398 SW 21ST LN
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City | MIAMI
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State | FL
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Zip | 33185-5730
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Country | US
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Telephone | 305-456-7325
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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 | 2471R0002X
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Taxonomy Name | Radiation Therapy Radiologic Technologist
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License Number | CRT43164
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License Number State | FL
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