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General NPI Number Information
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NPI Number | 1790231694
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Entity Type | Individual
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Provider Name | JUAN CARLOS ESTRADA ARNP
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Gender | Male
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 1170 S SEMORAN BLVD
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City | ORLANDO
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State | FL
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Zip | 32807-1458
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Country | US
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Telephone | 407-622-7246
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Fax | 407-599-7246
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Provider Business Mailing Address
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Address Line | 5365 W ATLANTIC AVE STE 504
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8194
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Country | US
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Telephone | 561-241-9300
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Fax | 561-241-9339
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9289150
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License Number State | FL
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