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General NPI Number Information
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NPI Number | 1811352669
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Entity Type | Individual
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Provider Name | JAVIER CHIRIBOGA
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Gender | Male
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 8545 JARED WAY
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City | BOCA RATON
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State | FL
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Zip | 33433-7644
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Country | US
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Telephone | 561-866-3953
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Fax |
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Provider Business Mailing Address
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Address Line | 15300 S JOG RD STE 101
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City | DELRAY BEACH
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State | FL
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Zip | 33446-2164
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Country | US
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Telephone | 561-819-3100
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Fax | 561-819-3119
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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 | APRN11007504
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License Number State | FL
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