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General NPI Number Information
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NPI Number | 1760045470
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Entity Type | Organization
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Legal Business Name | CITY CARE DOCTORS INC
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Dates
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Enumeration Date | 04/18/2019
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 14732 SW 56TH ST
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City | MIAMI
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State | FL
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Zip | 33185
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Country | US
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Telephone | 786-668-6396
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Fax |
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Provider Business Mailing Address
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Address Line | 14732 SW 56TH ST
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City | MIAMI
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State | FL
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Zip | 33185-4041
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Country | US
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Telephone | 786-668-6396
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Fax |
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Authorized Official
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Title or Position | ARNP
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Name | DORISLEY TRAVIESO
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Credential |
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Telephone | 305-766-4845
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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