Provider Demographics
NPI:1447256847
Name:LONG, REBECCA B (ARNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:B
Last Name:LONG
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:3301 SW 34TH CIR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6621
Mailing Address - Country:US
Mailing Address - Phone:352-861-0100
Mailing Address - Fax:352-861-1119
Practice Address - Street 1:3301 SW 34TH CIR
Practice Address - Street 2:SUITE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6621
Practice Address - Country:US
Practice Address - Phone:352-861-0100
Practice Address - Fax:352-861-1119
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2013-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP973172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S85285Medicare UPIN