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General NPI Number Information
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NPI Number | 1750742524
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Entity Type | Organization
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Legal Business Name | INTERMED, LLC
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 3336 CALLE DONA JUANA URB. VISTA POINT
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-484-3063
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Fax |
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Provider Business Mailing Address
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Address Line | 3336 CALLE DONA JUANA URB. VISTA POINT
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-484-3063
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/TREASURER
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Name | DR. FELIX M CARATINI SOTO
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Credential | M.D.
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Telephone | 787-484-3063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 11854
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License Number State | PR
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