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General NPI Number Information
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NPI Number | 1649401720
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Entity Type | Individual
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Provider Name | JULIO C POVEDA M.D
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Gender | Male
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 19200 SW 377 ST
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City | FLORIDA CITY
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State | FL
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Zip | 33034
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Country | US
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Telephone | 305-242-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 15807 SW 99TH ST
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City | MIAMI
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State | FL
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Zip | 33196-6110
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Country | US
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Telephone | 305-382-2899
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Fax | 305-752-5096
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME69665
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License Number State | FL
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