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General NPI Number Information
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NPI Number | 1609775378
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Entity Type | Individual
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Provider Name | MARIA DIMAYUGA FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 1290 WESTON RD STE 203
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City | WESTON
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State | FL
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Zip | 33326-1909
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Country | US
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Telephone | 195-443-6803
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Fax |
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Provider Business Mailing Address
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Address Line | 839 REGAL COVE RD
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City | WESTON
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State | FL
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Zip | 33327-2141
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Country | US
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Telephone | 954-759-1889
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11043195
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License Number State | FL
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