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General NPI Number Information
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NPI Number | 1841695442
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Entity Type | Organization
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Legal Business Name | SAUL A. RODRIGUEZ M.D.
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 280 FOREST PARK CIRCLE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4919
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Country | US
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Telephone | 786-942-0579
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9733
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32417-0133
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Country | US
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Telephone | 786-942-0579
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAUL AHMED RODRIGUEZ
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Credential | M.D.
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Telephone | 786-942-0579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME15570
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License Number State | FL
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