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General NPI Number Information
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NPI Number | 1447589247
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Entity Type | Organization
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Legal Business Name | ACL GASTRO PSC
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | HOSPITAL METROPOLITANO 1785 CARR. 21 URB. LAS LOMAS SUITE 208
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City | GUAYNABO
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State | PR
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Zip | 00921
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Country | US
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Telephone | 787-220-4435
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Fax |
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Provider Business Mailing Address
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Address Line | LA FLORESTA 1000 CARR. 831 APT. 641
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-479-2004
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABDIEL CRUZ-LOUBRIEL
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Credential |
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Telephone | 787-479-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 15922
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License Number State | PR
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