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General NPI Number Information
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NPI Number | 1982201802
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Entity Type | Individual
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Provider Name | MARCOS C. PUENTE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/04/2020
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Last Update Date | 10/04/2020
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Provider Practice Location Address
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Address Line | 1625 E CAMELBACK RD
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City | PHOENIX
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State | AZ
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Zip | 85016-3901
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Country | US
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Telephone | 602-274-0810
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Fax |
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Provider Business Mailing Address
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Address Line | 18220 N 68TH ST. APT #285
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City | SCOTTSDALE
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State | AZ
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Zip | 85054
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Country | US
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Telephone | 317-514-5750
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | S024937
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License Number State | AZ
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