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NPI 1992392500

NPI 1992392500 : GENOSUR LLC : MIAMI, FL

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General NPI Number Information
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    NPI Number           |    1992392500
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    Entity Type          |    Organization 
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    Legal Business Name  |    GENOSUR LLC 
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Dates
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    Enumeration Date     |    12/29/2020
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    Last Update Date     |    12/29/2020
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Provider Practice Location Address
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    Address Line         |    1951 NW 7TH AVE STE 600 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33136-1128
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    Country              |    US
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    Telephone            |    844-436-6121
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    Fax                  |    281-786-2089
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Provider Business Mailing Address
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    Address Line         |    1951 NW 7TH AVE STE 600 
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    City                 |    MIAMI
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    State                |    FL
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    Zip                  |    33136-1128
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    Country              |    US
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    Telephone            |    844-436-6121
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    Fax                  |    281-786-2089
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Authorized Official
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    Title or Position    |    BILLING MANAGER
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    Name                 |     BRYNN  MARTINEZ 
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    Credential           |    
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    Telephone            |    832-434-8523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    291U00000X
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    Taxonomy Name        |    Clinical Medical Laboratory
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    License Number       |    
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    License Number State |    
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