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General NPI Number Information
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NPI Number | 1063326965
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Entity Type | Organization
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Legal Business Name | CRESTVIEW HOSPITAL COMPANY LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 400 REDSTONE AVE W
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City | CRESTVIEW
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State | FL
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Zip | 32536-8467
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Country | US
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Telephone | 850-689-8100
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Fax | 850-689-8488
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Provider Business Mailing Address
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Address Line | 151 E REDSTONE AVE
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City | CRESTVIEW
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State | FL
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Zip | 32539-5352
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Country | US
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Telephone | 850-689-8100
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Fax |
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Authorized Official
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Title or Position | SR DIRECTOR
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Name | PAULA LALOR
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Credential |
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Telephone | 629-215-3953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | NULL
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