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General NPI Number Information
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NPI Number | 1790142396
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Entity Type | Individual
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Provider Name | BENJAMIN AGUILAR
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Gender | Male
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Dates
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Enumeration Date | 01/27/2016
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Last Update Date | 01/27/2016
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Provider Practice Location Address
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Address Line | 6240 BRISTOL LN
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City | SPRING HILL
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State | FL
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Zip | 34609-1230
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Country | US
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Telephone | 352-942-6256
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Fax | 352-556-3868
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Provider Business Mailing Address
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Address Line | 6240 BRISTOL LN
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City | SPRING HILL
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State | FL
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Zip | 34609-1230
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Country | US
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Telephone | 352-942-6256
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Fax | 352-556-3868
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | 6906821
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License Number State | FL
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