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General NPI Number Information
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NPI Number | 1659732618
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Entity Type | Organization
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Legal Business Name | HOSPICIO LUZ CELESTE L.L.C.
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | AVE LUIS MUNOZ MARIN H17A VILLA DEL CARMEN
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City | CAGUAS
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State | PR
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Zip | 00725-6158
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Country | US
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Telephone | 787-249-3433
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8427
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-249-3433
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOLIAN RIVERA
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Credential | M.D.
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Telephone | 787-249-3433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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