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General NPI Number Information
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NPI Number | 1730463274
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Entity Type | Organization
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Legal Business Name | THERAPY-DIAGNOSTIC, TECH MEDICAL INC.
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 5870 SW 8TH ST STE 2
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City | WEST MIAMI
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State | FL
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Zip | 33144-5052
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Country | US
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Telephone | 305-262-8811
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Fax | 305-262-8844
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Provider Business Mailing Address
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Address Line | 5870 SW 8TH ST STE 2
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City | WEST MIAMI
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State | FL
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Zip | 33144-5052
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Country | US
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Telephone | 305-262-8811
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Fax | 305-262-8844
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CARLOS DIEGUEZ
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Credential |
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Telephone | 305-262-8811
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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 |
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License Number State |
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