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General NPI Number Information
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NPI Number | 1538853395
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Entity Type | Organization
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Legal Business Name | MEDTOUR LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 10305 NW 41ST ST STE 203
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City | DORAL
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State | FL
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Zip | 33178-2982
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Country | US
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Telephone | 786-780-1180
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Fax | 305-356-3617
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Provider Business Mailing Address
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Address Line | 10305 NW 41ST ST STE 203
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City | DORAL
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State | FL
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Zip | 33178-2982
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Country | US
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Telephone | 786-780-1180
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Fax | 305-356-3617
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DELIA ROSA RINCON
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Credential |
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Telephone | 786-780-1180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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