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General NPI Number Information
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NPI Number | 1306742606
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Entity Type | Individual
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Provider Name | LUIS MIGUEL JIMENEZ TORRES
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Gender | Male
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Dates
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Enumeration Date | 10/15/2026
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Last Update Date | 10/15/2026
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Provider Practice Location Address
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Address Line | 388 CALLE DR. LUIS F SALAS
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City | PONCE
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State | PR
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Zip | 00716-2575
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Country | US
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Telephone | 787-840-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 11545 NW 92ND AVE
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City | HIALEAH
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State | FL
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Zip | 33018-4144
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Country | US
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Telephone | 786-890-3810
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 018
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License Number State | PR
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