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General NPI Number Information
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NPI Number | 1841871803
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Entity Type | Organization
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Legal Business Name | VALORA MEDICAL GROUP LLC
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 04/20/2021
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Provider Practice Location Address
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Address Line | 1250 E PIONEER PKWY
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City | ARLINGTON
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State | TX
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Zip | 76010-6422
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Country | US
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Telephone | 844-825-6724
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Fax |
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Provider Business Mailing Address
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Address Line | 9369 BLANCHE COVE DRIVE
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City | WINDERMERE
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State | FL
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Zip | 34786
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Country | US
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Telephone | 407-460-1292
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | PATRICIA D PICHARDO
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Credential |
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Telephone | 407-460-1292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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