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General NPI Number Information
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NPI Number | 1598027427
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Entity Type | Organization
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Legal Business Name | JUAN E. BATISTA #2
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 4623 FOREST HILL BLVD SUITE 112
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9121
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Country | US
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Telephone | 561-433-0080
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Fax | 561-433-1668
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Provider Business Mailing Address
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Address Line | 4623 FOREST HILL BLVD SUITE 112
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9121
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Country | US
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Telephone | 561-433-0080
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Fax | 561-433-1668
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMPARO GONZALEZ
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Credential |
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Telephone | 561-433-0080
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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 | ME109755
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License Number State | FL
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