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General NPI Number Information
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NPI Number | 1801092028
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Entity Type | Organization
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Legal Business Name | ANI, LLC
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 509 BROOKWOOD BLVD
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6801
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Country | US
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Telephone | 205-414-9850
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Fax | 205-414-9855
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Provider Business Mailing Address
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Address Line | 509 BROOKWOOD BLVD
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6801
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Country | US
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Telephone | 205-414-9850
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Fax | 205-414-9855
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Authorized Official
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Title or Position | MEDICAL PROVIDER
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Name | CAMILO R GOMEZ
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Credential | M.D.
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Telephone | 205-874-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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