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General NPI Number Information
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NPI Number | 1306942602
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Entity Type | Organization
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Legal Business Name | SYNOVATION MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 7000 SW 62ND AVE STE 535
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4724
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Country | US
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Telephone | 786-268-4044
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Fax | 866-206-8118
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Provider Business Mailing Address
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Address Line | PO BOX 12949
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City | MIAMI
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State | FL
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Zip | 33101-2949
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Country | US
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Telephone | 954-457-0064
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Fax | 855-490-4044
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Authorized Official
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Title or Position | MANAGER-MEMBER
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Name | CLAYTON A VARGA
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Credential | MD
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Telephone | 305-428-7733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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