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General NPI Number Information
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NPI Number | 1811980915
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Entity Type | Individual
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Provider Name | VICTOR MANUEL ROSA REYES OD
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Gender | Male
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | HIGHWAY 185 K15.5
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-752-1417
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Fax | 787-787-9576
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Provider Business Mailing Address
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Address Line | PO BOX 1229
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City | JUNCOS
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State | PR
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Zip | 00777-1229
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Country | US
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Telephone | 787-752-1417
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Fax | 787-787-9576
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 432
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License Number State | PR
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