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General NPI Number Information
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NPI Number | 1447966569
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Entity Type | Organization
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Legal Business Name | RESTORATIVE RHEUMATOLOGY & ARTHRITIS CLINIC, LLC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 499 E CENTRAL PKWY STE 205
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3450
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Country | US
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Telephone | 407-212-7693
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Fax |
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Provider Business Mailing Address
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Address Line | 499 E CENTRAL PKWY STE 205
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-3450
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Country | US
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Telephone | 407-212-7693
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | LESLIE BENNY
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Credential | D.O.
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Telephone | 407-212-7693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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