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General NPI Number Information
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NPI Number | 1801887518
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Entity Type | Individual
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Provider Name | LYNNETTE RUIZ MD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 1962 N JOHN YOUNG PKWY USA MED CARE
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City | KISSIMMEE
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State | FL
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Zip | 34741
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Country | US
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Telephone | 407-935-0623
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Fax | 407-809-5245
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Provider Business Mailing Address
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Address Line | 2586 TANDORI CIR
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City | ORLANDO
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State | FL
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Zip | 32837-7521
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Country | US
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Telephone | 939-644-3118
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14989
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN522
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License Number State | FL
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