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General NPI Number Information
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NPI Number | 1528459666
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Entity Type | Individual
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Provider Name | LAZARO R COMPLETO JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/11/2015
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | #C-823 2400 SOUTH OCEAN DRIVE
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City | FORT PIERCE
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State | FL
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Zip | 34949
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Country | US
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Telephone | 772-359-5898
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Fax |
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Provider Business Mailing Address
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Address Line | #C-823 2400 SOUTH OCEAN DRIVE
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City | FORT PIERCE
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State | FL
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Zip | 34949
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME24174
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License Number State | FL
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