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General NPI Number Information
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NPI Number | 1992269468
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Entity Type | Organization
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Legal Business Name | RHEUMATOLOGY CENTER OF PALM BEACH PLLC
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Dates
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Enumeration Date | 01/29/2019
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Last Update Date | 01/29/2019
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Provider Practice Location Address
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Address Line | 3918 VIA POINCIANA STE 2
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City | LAKE WORTH
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State | FL
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Zip | 33467-2991
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Country | US
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Telephone | 561-969-1261
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8689
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City | JUPITER
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State | FL
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Zip | 33468-8689
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Country | US
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Telephone | 561-748-2889
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Fax | 561-748-1523
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUAN JOSE MAYA VILLAMIZAR
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Credential | MD
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Telephone | 216-688-6996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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