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General NPI Number Information
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NPI Number | 1194635532
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Entity Type | Organization
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Legal Business Name | ADVENTHEALTH PRIMARY CARE RMR
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 4141 PLUM CREEK BLVD UNIT 200
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City | CASTLE ROCK
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State | CO
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Zip | 80104-4130
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Country | US
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Telephone | 720-455-8003
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Fax | 720-985-2087
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Provider Business Mailing Address
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Address Line | 2600 WESTHALL LN STE 200
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City | MAITLAND
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State | FL
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Zip | 32751-7107
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Country | US
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Telephone | 407-200-2857
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DESTIN HARCUS
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Credential |
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Telephone | 225-328-1607
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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