Healthcare Provider Details

I. General information

NPI: 1831009802
Provider Name (Legal Business Name): ADVENTHEALTH PRIMARY CARE RMR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 N MAIN ST STE 200
AURORA CO
80019-3008
US

IV. Provider business mailing address

2600 WESTHALL LN STE 200
MAITLAND FL
32751-7107
US

V. Phone/Fax

Practice location:
  • Phone: 720-455-3957
  • Fax: 720-239-6515
Mailing address:
  • Phone: 407-200-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DESTIN HARCUS
Title or Position: CFO
Credential:
Phone: 225-328-1607