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General NPI Number Information
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NPI Number | 1457591919
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Entity Type | Individual
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Provider Name | JANICE SALAS VINCENTY O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1018 AVE ASHFORD SUITE 1 A
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City | SAN JUAN
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State | PR
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Zip | 00907-2108
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Country | US
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Telephone | 787-624-3430
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Fax |
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Provider Business Mailing Address
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Address Line | BE24 PLAZA 13
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-6049
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 627
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License Number State | PR
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