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General NPI Number Information
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NPI Number | 1427958073
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT MOBILE PRIMARY CARE , LLC
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Dates
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Enumeration Date | 11/07/2026
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Last Update Date | 11/07/2026
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Provider Practice Location Address
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Address Line | 407 S PARK AVE
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City | APOPKA
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State | FL
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Zip | 32703-5261
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Country | US
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Telephone | 407-549-6503
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Fax |
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Provider Business Mailing Address
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Address Line | 2445 S HIAWASSEE RD UNIT 2065
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City | ORLANDO
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State | FL
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Zip | 32835-6347
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Country | US
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Telephone | 407-549-6503
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Fax |
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Authorized Official
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Title or Position | ADVANCE NURSE PRACTITIONER
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Name | MOYETTE PATRICE GRAHAM-THOMAS
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Credential | APRN-C
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Telephone | 407-549-6503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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