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Organization
ADVENTHEALTH PRIMARY CARE NETWORK INC
Active
Organization
ADVENTHEALTH PRIMARY CARE NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY J PETTIJOHN (SVP-CFO)
(407) 357-1000
Entity
Organization
Contact information
Practice address
900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714-1502
(407) 357-1000
Mailing address
900 HOPE WAY, ALTAMONTE SPRINGS, FL 32714-1502
(407) 357-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
07/05/2023
Last updated
09/15/2023
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