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General NPI Number Information
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NPI Number | 1912965930
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Entity Type | Individual
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Provider Name | LUIS EDUARDO CARDENAS DMD
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 1 SW 129TH AVE SUITE 400
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1761
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Country | US
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Telephone | 954-432-2080
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Fax | 954-432-5560
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Provider Business Mailing Address
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Address Line | 5531 N UNIVERSITY DR SUITE 104
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4649
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Country | US
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Telephone | 954-227-4892
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Fax | 954-227-4894
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN13740
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License Number State | FL
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