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1619571726
GLENN HERNANDEZ DERIT
LEESBURG, FL
NPI
1619571726
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: FL 11010307)
Enumeration Date
2020-11-30
Last Update Date
2020-11-30
Business Address
GLENN HERNANDEZ DERIT APRN
2201 NICOLLETT WAY
LEESBURG, FL 34748-2945
Phone number: 352-360-8635
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Mailing Address
GLENN HERNANDEZ DERIT APRN
2201 NICOLLETT WAY
LEESBURG, FL 34748-2945
Phone number: 352-360-8635
Copy
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