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General NPI Number Information
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NPI Number | 1851018659
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Entity Type | Organization
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Legal Business Name | MYOHEALTH
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Dates
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Enumeration Date | 10/21/2022
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1475 NW 97TH AVE STE 101
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City | DORAL
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State | FL
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Zip | 33172-2819
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Country | US
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Telephone | 305-915-3638
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N 73RD TER
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City | HOLLYWOOD
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State | FL
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Zip | 33024-7140
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | LAZARO GONZALEZ
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Credential | APRN
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Telephone | 305-915-3638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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