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General NPI Number Information
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NPI Number | 1497940720
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Entity Type | Organization
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Legal Business Name | AVENTIST HEALTH SYSTEMS/SUNBELT, INC.
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 12500 S APOPKA VINELAND RD
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City | ORLANDO
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State | FL
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Zip | 32836-6723
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Country | US
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Telephone | 407-934-2273
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Fax | 407-934-2279
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Provider Business Mailing Address
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Address Line | 901 N LAKE DESTINY RD SUITE 400
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City | MAITLAND
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State | FL
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Zip | 32751-4844
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Country | US
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Telephone | 407-200-2860
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Fax | 407-200-1365
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT C BRADY
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Credential | M.D.
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Telephone | 407-200-2860
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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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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | OS 8766
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License Number State | FL
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