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General NPI Number Information
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NPI Number | 1972561199
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Entity Type | Individual
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Provider Name | AMY RUIZ GOMEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 04/15/2011
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Provider Practice Location Address
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Address Line | 1010 PASEO DEL VETRANO CLINICA DE VETERANO DE PONCE
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City | PONCE
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State | PR
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Zip | 00716-2001
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Country | US
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Telephone | 787-812-3030
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Fax |
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Provider Business Mailing Address
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Address Line | 16 CALLE CEIBA MANSIONES DEL SUR
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City | COTO LAUREL
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State | PR
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Zip | 00780-2076
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Country | US
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Telephone | 787-840-3164
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11743
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License Number State | PR
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