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General NPI Number Information
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NPI Number | 1619634136
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Entity Type | Organization
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Legal Business Name | RELATED MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 633 N KROME AVE STE 1
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City | HOMESTEAD
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State | FL
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Zip | 33030-6043
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Country | US
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Telephone | 305-763-4007
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Fax | 305-847-0764
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Provider Business Mailing Address
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Address Line | 633 N KROME AVE STE 1
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City | HOMESTEAD
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State | FL
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Zip | 33030-6043
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Country | US
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Telephone | 305-763-4007
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Fax | 305-847-0764
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Authorized Official
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Title or Position | OWNER/ APRN
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Name | RAFAEL RAMON FERNANDEZ
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Credential | APRN
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Telephone | 786-326-4240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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