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General NPI Number Information
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NPI Number | 1356424394
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Entity Type | Individual
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Provider Name | ILEANA RAMUDO-TOWNSEND D.M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6500 COW PEN RD SUITE 104
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City | MIAMI LAKES
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State | FL
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Zip | 33014-6602
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Country | US
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Telephone | 786-507-1303
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Fax | 786-507-1477
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Provider Business Mailing Address
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Address Line | 6500 COW PEN RD SUITE 104
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City | MIAMI LAKES
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State | FL
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Zip | 33014-6602
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Country | US
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Telephone | 786-507-1303
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Fax | 786-507-1477
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN15343
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License Number State | FL
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