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General NPI Number Information
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NPI Number | 1578956173
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Entity Type | Organization
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Legal Business Name | UMOREN MEDICAL LLC
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 03/06/2015
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Provider Practice Location Address
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Address Line | 6551 CONSTANCE ST
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City | LAKE WORTH
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State | FL
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Zip | 33467-7661
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Country | US
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Telephone | 561-429-3625
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Fax |
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Provider Business Mailing Address
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Address Line | 6551 CONSTANCE ST
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City | LAKE WORTH
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State | FL
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Zip | 33467-7661
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Country | US
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Telephone | 561-429-3625
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DR. INEMESIT E UMOREN
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Credential |
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Telephone | 561-429-3625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME 103641
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License Number State | FL
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