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General NPI Number Information
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NPI Number | 1942611900
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Entity Type | Organization
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Legal Business Name | CENTRO ORTOPEDICO ESPECIALIZADO
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2360 AVE EDUARDO RUBERTE
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City | PONCE
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State | PR
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Zip | 00717-0304
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Country | US
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Telephone | 787-844-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8726
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City | PONCE
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State | PR
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Zip | 00732-8726
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Country | US
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Telephone | 787-844-8000
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Fax |
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Authorized Official
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Title or Position | PRESIDENTE
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Name | GILBERTO J ALVARADO DIAZ
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Credential | MD
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Telephone | 787-844-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 16456
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License Number State | PR
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