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General NPI Number Information
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NPI Number | 1750849568
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Entity Type | Organization
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Legal Business Name | LUZ MEDICAL CENTER LLC
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 13032 SW 133RD CT
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City | MIAMI
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State | FL
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Zip | 33186-5855
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Country | US
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Telephone | 786-345-7589
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Fax | 786-396-1466
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Provider Business Mailing Address
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Address Line | 8148 SW 163RD CT
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City | MIAMI
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State | FL
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Zip | 33193-5120
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Country | US
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Telephone | 786-376-5554
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Fax | 786-396-1466
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | AIMEE LEYVA LOPEZ
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Credential | APRN
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Telephone | 786-376-5554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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