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General NPI Number Information
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NPI Number | 1861769556
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Entity Type | Organization
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Legal Business Name | DOCTOR KIDS CENTER P.S.C.
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | AVENIDA LAS AMERICAS PISO # 1 HOSPITAL METROPOLITANO DR. PILA
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City | PONCE
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-848-5600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 801293
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City | COTO LAUREL
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State | PR
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Zip | 00780-1293
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Country | US
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Telephone | 787-848-5600
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Fax |
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | BRENLIZ M ROBLES
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Credential | MD
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Telephone | 787-718-3449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 13375
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License Number State | PR
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