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General NPI Number Information
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NPI Number | 1619972635
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Entity Type | Individual
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Provider Name | HUMBERTO SIMONETTI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 12/08/2023
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Provider Practice Location Address
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Address Line | HOSPITAL SAN LUCAS II LOBBY AVE TITO CASTRO CARR 14 BO MACHUELO
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City | PONCE
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-844-2080
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Fax | 787-841-4832
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Provider Business Mailing Address
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Address Line | P O BOX 7437
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City | PONCE
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State | PUERTO RICO
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Zip | 00732-7437
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Country | UM
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Telephone | 17872597727
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Fax | 17878414832
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 7884
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 7884
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License Number State | PR
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