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General NPI Number Information
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NPI Number | 1801026729
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Entity Type | Organization
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Legal Business Name | PRESTIGE WOUND CARE, CORP.
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | CARR 153 KM 9.5
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City | SANTA ISABEL
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State | PR
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Zip | 00757
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Country | US
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Telephone | 787-845-8100
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Fax | 787-845-8101
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Provider Business Mailing Address
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Address Line | PO BOX 2042
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City | COAMO
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State | PR
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Zip | 00769-4042
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Country | US
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Telephone | 787-845-8100
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Fax | 787-845-8101
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOEL ESPINOSA
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Credential |
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Telephone | 787-845-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | AMP451
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License Number State | PR
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