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General NPI Number Information
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NPI Number | 1356657951
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Entity Type | Organization
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Legal Business Name | VALMER MEDICAL OFFICE, CORP
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 777 E 25TH ST SUITE # 419
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City | HIALEAH
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State | FL
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Zip | 33013-3825
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Country | US
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Telephone | 305-677-9519
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Fax | 786-715-5397
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Provider Business Mailing Address
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Address Line | 777 E 25TH ST SUITE # 419
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City | HIALEAH
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State | FL
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Zip | 33013-3825
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Country | US
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Telephone | 305-677-9519
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Fax | 786-715-5397
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Authorized Official
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Title or Position | DIRECTOR
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Name | RAFAEL HECTOR VALDESPINO
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Credential | M.D
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Telephone | 305-677-9519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME104195
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License Number State | FL
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