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General NPI Number Information
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NPI Number | 1700822749
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Entity Type | Organization
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Legal Business Name | L C MEDICAL CENTER, INC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7000 W 12TH AVE
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City | HIALEAH
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State | FL
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Zip | 33014-5154
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Country | US
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Telephone | 305-362-6868
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Fax | 305-362-6870
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Provider Business Mailing Address
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Address Line | 13875 SW 20TH ST
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City | MIAMI
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State | FL
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Zip | 33175-7514
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Country | US
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Telephone | 305-244-2546
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Fax | 305-368-6870
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ISMAEL LABRADOR
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Credential | MD
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Telephone | 305-244-2546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME 92214
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License Number State | FL
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