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General NPI Number Information
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NPI Number | 1639326564
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Entity Type | Individual
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Provider Name | GERMAN ENRIQUE LUZARDO GRANADOS MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2008
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Last Update Date | 04/22/2020
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Provider Practice Location Address
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Address Line | 5731 BEE RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34233-5056
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Country | US
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Telephone | 941-342-2291
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Fax |
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Provider Business Mailing Address
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Address Line | 5053 SKYVIEW LN
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City | BRADENTON
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State | FL
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Zip | 34211-2313
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Country | US
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Telephone | 772-475-0436
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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 | ME103190
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | TRN11689
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License Number State | FL
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