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General NPI Number Information
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NPI Number | 1750450169
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Entity Type | Individual
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Provider Name | JOHN M MIGUELEZ CP
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2 WRAMC SUITE 3H 6900 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20307-0001
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Country | US
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Telephone | 202-782-9830
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Fax | 202-782-4365
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Provider Business Mailing Address
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Address Line | 123 W TORRANCE BLVD SUITE 203
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3610
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Country | US
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Telephone | 310-372-3050
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Fax | 310-372-3057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number | CP001751
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License Number State | DC
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