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General NPI Number Information
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NPI Number | 1851687800
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Entity Type | Individual
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Provider Name | MR. LUIS GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 145 MADEIRA AVE STE 202
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City | CORAL GABLES
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State | FL
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Zip | 33134-4520
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Country | US
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Telephone | 305-567-2797
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Fax |
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Provider Business Mailing Address
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Address Line | 145 MADEIRA AVE SUITE 202
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City | MIAMI
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State | FL
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Zip | 33134
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Country | US
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Telephone | 305-567-2797
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | FL
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