NPI Code Detail JSON Logo

1023687530 NPI number — OLIVIA KEHOE DYKO CAA

NPI Number: 1023687530
Health Care Provider/Practitioner: OLIVIA KEHOE DYKO CAA

Information about “1023687530” NPI (OLIVIA KEHOE DYKO CAA) exists in 1023687530 in HTML format HTML  |  1023687530 in plain Text format TXT  |  1023687530 in PDF (Portable Document Format) PDF  |  1023687530 in an XML format XML  formats.

NPI Number : 1023687530 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023687530",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DYKO",
    "FirstName": "OLIVIA",
    "MiddleName": "KEHOE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "CAA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "240 CRANES LAKE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PONTE VEDRA BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32082-1617",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "800 PRUDENTIAL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32207-8202",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-202-2000",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/18/2021",
    "LastUpdateDate": "06/25/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "367H00000X",
          "TaxonomyName": "Anesthesiologist Assistant",
          "LicenseNumber": "67.000408",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "367H00000X",
          "TaxonomyName": "Anesthesiologist Assistant",
          "LicenseNumber": "AA810",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.