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General NPI Number Information
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NPI Number | 1396357778
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Entity Type | Individual
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Provider Name | LEONEL MARTINEZ
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Gender | Male
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Dates
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Enumeration Date | 08/18/2020
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Last Update Date | 08/18/2020
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Provider Practice Location Address
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Address Line | 4870 SADLER RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6294
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Country | US
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Telephone | 804-424-2651
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Fax |
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Provider Business Mailing Address
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Address Line | 650 SE 9TH CT APT 105
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City | HIALEAH
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State | FL
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Zip | 33010-5767
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Country | US
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Telephone | 786-295-3468
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Fax |
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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 | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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