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General NPI Number Information
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NPI Number | 1518875996
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Entity Type | Organization
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Legal Business Name | FABIO LLC
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 201 AVE JOSE GAUTIER BENITEZ SUITE 307 CONSOLIDATED MEDICAL PLAZA
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City | CAGUAS
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State | PR
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Zip | 00725-5527
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Country | US
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Telephone | 787-746-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 690 CALLE CESAR GONZALEZ APT 2303
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City | SAN JUAN
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State | PR
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Zip | 00918-3907
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Country | US
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Telephone | 573-825-8673
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FABIO SQUICIMARI DE CARDENAS
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Credential | MD
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Telephone | 573-825-8673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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