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General NPI Number Information
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NPI Number | 1679266639
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Entity Type | Individual
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Provider Name | RITA MARIE OSTENDORP APRN
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Gender | Female
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 11/05/2026
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Provider Practice Location Address
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Address Line | 1785 WAVERLY PL STE A
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City | MELBOURNE
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State | FL
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Zip | 32901-4641
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Country | US
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Telephone | 321-216-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 4771 LONGBOW DR
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City | TITUSVILLE
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State | FL
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Zip | 32796-1402
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Country | US
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Telephone | 321-576-5927
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11035196
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License Number State | FL
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