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NPI 1922350933

NPI 1922350933 : MISALITA : BROWNSVILLE, TX

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General NPI Number Information
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    NPI Number           |    1922350933
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    Entity Type          |    Organization 
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    Legal Business Name  |    MISALITA 
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Dates
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    Enumeration Date     |    10/15/2012
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    Last Update Date     |    10/15/2012
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Provider Practice Location Address
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    Address Line         |    3380 RUBEN TORRES BLVD 202
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    City                 |    BROWNSVILLE
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    State                |    TX
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    Zip                  |    78526
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    Country              |    US
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    Telephone            |    956-592-6988
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    822 E BUCHANAN ST 
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    City                 |    HARLINGEN
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    State                |    TX
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    Zip                  |    78550-7246
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     ALEJANDRO  ROMERO 
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    Credential           |    
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    Telephone            |    956-536-9146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    
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    License Number State |    
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