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General NPI Number Information
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NPI Number | 1386764751
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Entity Type | Organization
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Legal Business Name | CENTRO DE ONCOLOGIA Y HEMATOLOGIA
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 735 AVE PONCE DE LEON TORRE AUXILIO MUTUO STE 416
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City | SAN JUAN
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State | PR
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Zip | 00917-5022
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Country | US
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Telephone | 787-751-0373
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Fax | 787-751-5517
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Provider Business Mailing Address
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Address Line | PO BOX 363986
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City | SAN JUAN
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State | PR
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Zip | 00936-3986
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Country | US
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Telephone | 787-751-0373
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Fax | 787-751-5517
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DALIA I RUIZ
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Credential | NURSE
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Telephone | 787-751-0373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 6441
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License Number State | PR
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