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General NPI Number Information
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NPI Number | 1861052151
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Entity Type | Individual
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Provider Name | ANDRES MANUEL CRUZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 6839 COLLIER BLVD STE 103
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City | NAPLES
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State | FL
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Zip | 34114-3632
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Country | US
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Telephone | 239-465-4568
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Fax |
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Provider Business Mailing Address
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Address Line | 8150 SW 88TH CT
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City | MIAMI
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State | FL
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Zip | 33173-4149
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Country | US
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Telephone | 305-310-5644
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN24273
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License Number State | FL
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