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General NPI Number Information
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NPI Number | 1821430828
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Entity Type | Individual
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Provider Name | MICHAEL STEVEN MAYICH MD, FRCPC
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Gender | Male
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR BCVI 3RD FLOOR, PHYSICIANS OFFICICES
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 8900 N KENDALL DR BCVI 3RD FLOOR, PHYSICIANS OFFICICES
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-5990
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 036131922
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 119713
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License Number State | FL
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