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Organization
REJUVENATION CARE CLINIC OF CENTRAL FLORIDA
Active
Organization
REJUVENATION CARE CLINIC OF CENTRAL FLORIDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAXTON COPELAND III (PRESIDENT)
(800) 641-9128
Entity
Organization
Contact information
Practice address
2541 S VOLUSIA AVE STE 100, ORANGE CITY, FL 32763-9116
(800) 641-9128
Mailing address
12221 E COLONIAL DR APT 1105, ORLANDO, FL 32826-4762
(800) 641-9128
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L19000063350
STATE LICENSE NUMBER
FL
Enumeration date
04/02/2019
Last updated
11/15/2024
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