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General NPI Number Information
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NPI Number | 1275382798
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Entity Type | Individual
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Provider Name | JESSICA HEMOTA APRN
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Gender | Female
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Dates
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Enumeration Date | 05/16/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 2000 FOWLER GROVE BLVD
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5050
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Country | US
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Telephone | 407-609-7395
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 FOWLER GROVE BLVD STE 300
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5597
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Country | US
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Telephone | 407-559-8736
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Fax | 407-614-0796
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11031764
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11031764
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License Number State | FL
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