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General NPI Number Information
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NPI Number | 1467744722
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Entity Type | Organization
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Legal Business Name | CLINICA DE MEDICINA ESPECIALIZADA CAGUAS, INC.
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Dates
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Enumeration Date | 05/05/2011
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | CARR. #1 MARGINAL KM. 33.3 BO. BAIROA
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City | CAGUAS
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State | PR
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Zip | 00725-0000
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Country | US
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Telephone | 787-703-2632
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Fax | 787-703-2636
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Provider Business Mailing Address
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Address Line | PMB 129 PO BOX 4956
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City | CAGUAS
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State | PR
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Zip | 00726-4956
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Country | US
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Telephone | 787-703-2632
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Fax | 787-703-2636
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/ADMINISTRATOR
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Name | MRS. MARIA T ROSA
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Credential |
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Telephone | 787-406-2410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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