NPI Code Detail JSON Logo

1003705062 NPI number — BRYONNA AGUIRRE

NPI Number: 1003705062
Health Care Provider/Practitioner: BRYONNA AGUIRRE

Information about “1003705062” NPI (BRYONNA AGUIRRE) exists in 1003705062 in HTML format HTML  |  1003705062 in plain Text format TXT  |  1003705062 in PDF (Portable Document Format) PDF  |  1003705062 in an XML format XML  formats.

NPI Number : 1003705062 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003705062",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "AGUIRRE",
    "FirstName": "BRYONNA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "27850 WOODVIEW DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ELKHART",
    "MailingAddressStateName": "IN",
    "MailingAddressPostalCode": "46517-8417",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "838 N DELAWARE ST STE 9",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46204-1127",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "312-972-7868",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/02/2025",
    "LastUpdateDate": "10/17/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "08/22/2025",
    "NPIReactivationDate": "10/17/2025",
    "GenderCode": "X",
    "Gender": null,
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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