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General NPI Number Information
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NPI Number | 1689897472
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Entity Type | Organization
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Legal Business Name | AC DIONISIO, MD INC.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4240 SIMMONS ST.
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City | N. LAS VEGAS
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State | NV
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Zip | 89032
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Country | US
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Telephone | 702-635-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 764 CANARY WHARF DR
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City | LAS VEGAS
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State | NV
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Zip | 89178-1276
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANGELITO DIONISIO
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Credential |
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Telephone | 702-635-1222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11926
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License Number State | NV
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