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General NPI Number Information
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NPI Number | 1639364128
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Entity Type | Organization
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Legal Business Name | JAIME TORO MD PA
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Dates
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Enumeration Date | 09/08/2007
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Last Update Date | 09/08/2007
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Provider Practice Location Address
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Address Line | 1800 SE TIFFANY AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7521
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Country | US
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Telephone | 772-335-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 900 E PRIMA VISTA BLVD SUITE 200
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-2366
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Country | US
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Telephone | 772-621-3059
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Fax | 772-621-3181
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAIME TORO
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Credential | M.D.
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Telephone | 561-310-9147
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME48674
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License Number State | FL
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