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General NPI Number Information
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NPI Number | 1487801106
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Entity Type | Organization
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Legal Business Name | MMR INSTITUTO DE MEDICINA DE FAMILLIA DEL OESTE
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 2 CALLE PROVIDENCIA BARRERO URB LOS ALAMOS
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-2179
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Country | US
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Telephone | 787-896-9000
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Fax | 787-896-9000
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Provider Business Mailing Address
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Address Line | PMB 336 PO BOX 7999
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City | MAYAGUEZ
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State | PR
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Zip | 00681
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Country | US
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Telephone | 787-896-9000
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Fax | 787-896-9000
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. ELIASIN MUNOZ
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Credential | M.D.
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Telephone | 787-896-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9121
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License Number State | PR
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