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General NPI Number Information
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NPI Number | 1942366331
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Entity Type | Organization
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Legal Business Name | ANGELORUM INC.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | CARR 693 KM 13.8 LOCAL 171 BO. BRENAS
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-270-5511
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Fax | 787-883-4400
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Provider Business Mailing Address
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Address Line | P.O. BOX 419
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City | VEGA ALTA
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State | PR
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Zip | 00692
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Country | US
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Telephone | 787-883-6718
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Fax | 787-270-5511
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. LUIS GONZALEZ SR.
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Credential | MD
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Telephone | 787-316-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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