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NPI 1659964732

NPI 1659964732 : FABIOLA P ROMERO URDANETA : TAMPA, FL

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General NPI Number Information
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    NPI Number           |    1659964732
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    Entity Type          |    Individual 
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    Provider Name        |    FABIOLA P ROMERO URDANETA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/18/2021
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    Last Update Date     |    02/19/2021
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Provider Practice Location Address
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    Address Line         |    2706 W SAINT ISABEL ST 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33607-6382
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    Country              |    US
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    Telephone            |    813-999-1311
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7034 PELICAN ISLAND DR 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33634-7469
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    Country              |    US
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    Telephone            |    786-860-0958
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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