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1033477179 NPI number — RICARDO DELVIA WHITE JR. LPN

NPI Number: 1033477179
Health Care Provider/Practitioner: RICARDO DELVIA WHITE JR. LPN

Information about “1033477179” NPI (RICARDO DELVIA WHITE JR. LPN) exists in 1033477179 in HTML format HTML  |  1033477179 in plain Text format TXT  |  1033477179 in PDF (Portable Document Format) PDF  |  1033477179 in an XML format XML  formats.

NPI Number : 1033477179 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033477179",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITE",
    "FirstName": "RICARDO",
    "MiddleName": "DELVIA",
    "NamePrefix": "MR.",
    "NameSuffix": "JR.",
    "Credential": "LPN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "WHITE",
    "OtherFirstName": "RICARDO",
    "OtherMiddleName": "DELVIA",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": "JR.",
    "OtherCredential": "LPN",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3098 KENSINGTON RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEVELAND HTS",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44118-3572",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "216-326-1683",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3098 KENSINGTON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEVELAND HTS",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44118-3572",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "216-326-1683",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/26/2012",
    "LastUpdateDate": "04/26/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "164W00000X",
        "TaxonomyName": "Licensed Practical Nurse",
        "LicenseNumber": "PN-134120M-IV",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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