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General NPI Number Information
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NPI Number | 1295859783
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Entity Type | Individual
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Provider Name | ROBINDRANATH PEREZ DIAZ M.T.
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 130 RD K.M. 11.6 CAMPO ALEGRE WD
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City | HATILLO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-820-5371
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Fax | 787-820-5371
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Provider Business Mailing Address
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Address Line | PO BOX 140267
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City | ARECIBO
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State | PR
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Zip | 00614-0267
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Country | US
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Telephone | 787-820-5371
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Fax | 787-820-5371
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 701
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License Number State | PR
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