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General NPI Number Information
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NPI Number | 1316996713
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Entity Type | Organization
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Legal Business Name | PRIME THERAPY, INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 4100 S FERDON BLVD STE A1
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City | CRESTVIEW
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State | FL
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Zip | 32536-5252
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Country | US
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Telephone | 850-682-8388
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Fax | 850-682-7463
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Provider Business Mailing Address
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Address Line | 4100 S. FERDON BLVD SUITE A1
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City | CRESTVIEW
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State | FL
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Zip | 32536-5287
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Country | US
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Telephone | 850-682-8388
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Fax | 850-682-7463
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. SABRA LYNN ARZAGA
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Credential | PT
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Telephone | 850-682-8388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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