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General NPI Number Information
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NPI Number | 1871031187
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Entity Type | Organization
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Legal Business Name | MYRIAM Z ALLENDE VIGO PSC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 18 CALLE J FRANCESCHI
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-852-5313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 364246
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City | SAN JUAN
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State | PR
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Zip | 00936-4246
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Country | US
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Telephone | 787-852-5313
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MYRIAM ZAYDEE ALLENDE
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Credential | MD
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Telephone | 787-502-1687
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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 |
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License Number State | PR
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