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General NPI Number Information
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NPI Number | 1366019812
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Entity Type | Organization
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Legal Business Name | SALUS MEDICAL GROUP
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 7824 LAKE UNDERHILL RD STE A
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City | ORLANDO
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State | FL
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Zip | 32822-8201
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Country | US
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Telephone | 407-282-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 11661 MEADOW GROVE CIR
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City | ORLANDO
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State | FL
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Zip | 32836-5049
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Country | US
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Telephone | 787-399-2999
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Fax |
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Authorized Official
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Title or Position | LEAD PHYSICIAN
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Name | LUISA M NIEVES
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Credential | MD
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Telephone | 787-399-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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