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General NPI Number Information
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NPI Number | 1821863770
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Entity Type | Organization
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Legal Business Name | VERNU 2
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 6775 CROSSWINDS DR N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-5471
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Country | US
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Telephone | 678-580-3823
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Fax |
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Provider Business Mailing Address
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Address Line | 6775 CROSSWINDS DR N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-5471
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Country | US
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Telephone | 678-580-3823
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KELLY C MCCANTS
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Credential |
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Telephone | 678-855-6535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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