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Individual
CARLOS A FONTE
Active
Individual
CARLOS A FONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ORTL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3242
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3242
STATE LICENSE
SC
Enumeration date
07/24/2007
Last updated
07/24/2007
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