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General NPI Number Information
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NPI Number | 1346292042
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Entity Type | Individual
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Provider Name | CARLOS C MAESTRE-FERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | #6 U3 CARR 21 LAS LOMAS
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City | SAN JUAN
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-793-6867
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Fax | 787-782-1565
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Provider Business Mailing Address
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Address Line | PO BOX 11484 CAPARRA HEIGHTS STATION
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City | SAN JUAN
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State | PR
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Zip | 00922-1484
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Country | US
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Telephone | 787-782-6030
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Fax | 787-782-1565
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 3276
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License Number State | PR
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