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General NPI Number Information
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NPI Number | 1619259587
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Entity Type | Individual
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Provider Name | KAYLENE RAQUEL MUNOZ
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 09/15/2011
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Provider Practice Location Address
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Address Line | 17621 SW 115 AVE
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City | MIAMI
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State | FL
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Zip | 33157
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Country | US
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Telephone | 305-303-0839
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Fax |
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Provider Business Mailing Address
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Address Line | 103 E LUCY ST #135
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City | HOMESTEAD
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State | FL
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Zip | 33034-2501
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Country | US
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Telephone | 305-245-5502
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | MA46249
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License Number State | FL
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