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General NPI Number Information
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NPI Number | 1588669204
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF CORAL GABLES, LLC
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 2645 DOUGLAS ROAD SUITE 400
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City | MIAMI
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State | FL
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Zip | 33133-2744
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Country | US
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Telephone | 305-461-3229
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Fax | 305-461-3288
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Provider Business Mailing Address
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Address Line | 2645 DOUGLAS ROAD SUITE 400
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City | MIAMI
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State | FL
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Zip | 33133-2744
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Country | US
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Telephone | 305-461-3229
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Fax | 305-461-3288
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JAMES SEYMOUR
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Credential | CASC
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Telephone | 305-461-3229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 1163
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License Number State | FL
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