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General NPI Number Information
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NPI Number | 1851542013
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Entity Type | Organization
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Legal Business Name | INTENSIVO LLC
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1 MEMORIAL DR
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City | ALTON
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State | IL
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Zip | 62002-6722
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Country | US
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Telephone | 314-989-9122
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Fax | 636-333-4510
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Provider Business Mailing Address
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Address Line | PO BOX 790379
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City | SAINT LOUIS
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State | MO
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Zip | 63179-0379
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Country | US
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Telephone | 314-989-9122
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Fax | 636-333-4510
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. SALVADOR LOBIANCO
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Credential | M.D.
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Telephone | 149-899-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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