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General NPI Number Information
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NPI Number | 1659560332
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Entity Type | Individual
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Provider Name | LUIS JUAREZ MD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 230 W 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3714
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Country | US
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Telephone | 305-825-9057
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Fax | 305-285-3135
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Provider Business Mailing Address
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Address Line | 230 W 49TH ST
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City | HIALEAH
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State | FL
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Zip | 33012-3714
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Country | US
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Telephone | 305-825-9057
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Fax | 305-285-3135
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME40343
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License Number State | FL
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