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General NPI Number Information
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NPI Number | 1841223104
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Entity Type | Organization
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Legal Business Name | DEMORIZI & POLANCO MDS PA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 8500 SW 92ND ST STUIE 101
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City | MIAMI
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State | FL
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Zip | 33156-7390
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Country | US
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Telephone | 305-279-3878
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Fax | 786-235-0384
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Provider Business Mailing Address
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Address Line | 8500 SW 92ND ST STUIE 101
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City | MIAMI
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State | FL
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Zip | 33156-7390
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Country | US
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Telephone | 305-279-3878
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Fax | 786-235-0384
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Authorized Official
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Title or Position | CEO
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Name | DR. NESTOR M DEMORIZI
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Credential | MD
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Telephone | 305-279-3878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 363853-4
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License Number State | FL
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