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General NPI Number Information
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NPI Number | 1700072949
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Entity Type | Organization
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Legal Business Name | ARMANDO FUENTES, MD PA
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 147 MORAY LN
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City | WINTER PARK
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State | FL
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Zip | 32792-4120
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Country | US
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Telephone | 407-644-9797
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Fax | 407-644-8377
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Provider Business Mailing Address
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Address Line | PO BOX 817
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City | WINTER PARK
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State | FL
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Zip | 32790-0817
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Country | US
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Telephone | 407-644-9797
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Fax | 407-644-8377
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Authorized Official
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Title or Position | OWNER
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Name | DR. ARMANDO FUENTES
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Credential | MD
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Telephone | 407-644-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME48481
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License Number State | FL
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