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General NPI Number Information
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NPI Number | 1619962446
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Entity Type | Individual
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Provider Name | JOSE RAMON FUENTES RODRIGUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | #8 C. LUZ CELENIA TIRADO
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-529-5545
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Fax |
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Provider Business Mailing Address
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Address Line | BOX 216 SECTOR ESPINOZA
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City | BAYAMON
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State | PR
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Zip | 00960
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Country | US
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Telephone | 787-529-5545
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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 | 6899
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License Number State | PR
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