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General NPI Number Information
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NPI Number | 1184124372
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Entity Type | Individual
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Provider Name | JASON W REGRUIT PT, DPT, MS, CSCS
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Gender | Male
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 8770 MAITLAND SUMMIT BLVD
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City | ORLANDO
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State | FL
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Zip | 32810-5934
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Country | US
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Telephone | 585-362-1433
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Fax |
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Provider Business Mailing Address
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Address Line | 8770 MAITLAND SUMMIT BLVD UNIT 2414
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City | ORLANDO
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State | FL
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Zip | 32810-6017
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Country | US
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Telephone |
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL7618
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | PT38613
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT38613
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License Number State | FL
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