MEDICARE: AVENTIST HEALTH SYSTEMS/SUNBELT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	208000000X	Pediatrics Physician
3	261QU0200X	Urgent Care Clinic/Center
4	363A00000X	Physician Assistant
5	363LF0000X	Family Nurse Practitioner
6	332900000X	Non-Pharmacy Dispensing Site	OS 8766	FL

General Provider Information

NPI Number	:	1497940720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVENTIST HEALTH SYSTEMS/SUNBELT, INC.

Provider Business Mailing Address
First Line	:	901 N LAKE DESTINY RD
Second Line	:	SUITE 400
City	:	MAITLAND
State	:	FL
Zip	:	32751-4844
Country	:	US
Telephone Number	:	407-200-2860
Fax Number	:	407-200-1365

Provider Business Practice Location Address
First Line	:	12500 S APOPKA VINELAND RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-6723
Country	:	US
Telephone Number	:	407-934-2273
Fax Number	:	407-934-2279

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCOTT C BRADY
Credential	:	M.D.
Telephone Number	:	407-200-2860

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	04/17/2023

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