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General NPI Number Information
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NPI Number | 1093710790
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Entity Type | Individual
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Provider Name | JOHN RICHARD HURT II M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 511 MEDICAL PLAZA DR
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City | LEESBURG
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State | FL
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Zip | 34748-7326
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Country | US
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Telephone | 352-728-6808
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Fax | 352-728-3637
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Provider Business Mailing Address
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Address Line | 511 MEDICAL PLAZA DR
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City | LEESBURG
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State | FL
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Zip | 34748-7326
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Country | US
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Telephone | 352-728-6808
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Fax | 352-728-3637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME74929
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME 74929
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License Number State | FL
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