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General NPI Number Information
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NPI Number | 1720426711
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE OPHTHALMOLOGY SERVICES LLC
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 283 CAMINO DEL MANGO SABANERA DEL RIO
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City | GURABO
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State | PR
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Zip | 00778
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Country | US
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Telephone | 787-529-6970
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Fax |
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Provider Business Mailing Address
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Address Line | 283 CAMINO DEL MANGO SABANERA DEL RIO
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City | GURABO
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State | PR
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Zip | 00778-5243
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Country | US
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Telephone | 787-529-6970
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. ANGEL L RIVERA-CASTRO
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Credential | MD
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Telephone | 787-529-6970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 11864
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License Number State | PR
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