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General NPI Number Information
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NPI Number | 1538585666
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTHCARE CENTER,INC
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Dates
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Enumeration Date | 03/13/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 1551 CALLE VICTORIA
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City | SANTURCE
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State | PR
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Zip | 00912-3123
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Country | US
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Telephone | 787-724-6063
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9023879
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City | SAN JUAN
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State | PR
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Zip | 00902-3879
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Country | US
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Telephone | 787-722-9595
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | MS. EDNA VAZQUEZ GORDIS
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Credential |
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Telephone | 787-406-8932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000531
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License Number State | PR
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