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Organization

FLORIDA FACILITISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN HANSON RAUCH (MANAGER)
(321) 273-0301
Entity
Organization

Contact information

Practice address
1450 W LAKE BRANTLEY RD, LONGWOOD, FL 32779-4766
(321) 273-0301
Mailing address
2000 PREVATT ST, SUITE B3, EUSTIS, FL 32726-6149
(321) 273-0301

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
06/12/2006
Last updated
09/11/2025
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