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General NPI Number Information
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NPI Number | 1598841918
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Entity Type | Individual
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Provider Name | CARLOS R BOU M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1451 AVE ASHFORD SECOND FLOOR, OR
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City | SAN JUAN
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State | PR
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Zip | 00907-1511
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Country | US
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Telephone | 787-722-2350
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Fax | 787-725-3630
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Provider Business Mailing Address
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Address Line | LE89 VIA PARIS L'ANTIGUA, ENCANTADA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-6106
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 13219
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License Number State | PR
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