Individual
DR. JOHN RICHARD HURT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 MEDICAL PLAZA DR, LEESBURG, FL 34748-7326
(352) 728-6808
(352) 728-3637
Mailing address
511 MEDICAL PLAZA DR, LEESBURG, FL 34748-7326
(352) 728-6808
(352) 728-3637
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME74929
FL
207RI0011X
Interventional Cardiology Physician
ME 74929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0108467
—
OH
05
—
01484956
—
PA
01
—
593516436003
TRICARE
—
01
—
695956
TUFTS
—
01
—
773114
MAILHANDLERS
—
01
—
7914953
MAMSI
—
01
—
92419
BCBS FLORIDA
—
01
—
P00391218
GBA RR PALMETTO
—
Enumeration date
06/17/2005
Last updated
04/17/2008
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