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General NPI Number Information
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NPI Number | 1598989790
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Entity Type | Organization
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Legal Business Name | CENTRO PULMONAR DE MANATI
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | E36 CALLE HERNANDEZ CARRION URB ATENAS
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City | MANATI
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State | PR
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Zip | 00674-4622
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Country | US
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Telephone | 787-884-4478
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Fax | 787-884-4495
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Provider Business Mailing Address
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Address Line | E36 CALLE HERNANDEZ CARRION URB ATENAS
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City | MANATI
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State | PR
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Zip | 00674-4622
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Country | US
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Telephone | 787-884-4478
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Fax | 787-884-4495
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL A AMILL ACOSTA
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Credential | M.D.
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Telephone | 787-884-4477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 6112
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License Number State |
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