NPI Code Detail JSON Logo

1063091197 NPI number — VICTORIA CATHERINE GREENWELL

NPI Number: 1063091197
Health Care Provider/Practitioner: VICTORIA CATHERINE GREENWELL

Information about “1063091197” NPI (VICTORIA CATHERINE GREENWELL) exists in 1063091197 in HTML format HTML  |  1063091197 in plain Text format TXT  |  1063091197 in PDF (Portable Document Format) PDF  |  1063091197 in an XML format XML  formats.

NPI Number : 1063091197 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063091197",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREENWELL",
    "FirstName": "VICTORIA",
    "MiddleName": "CATHERINE",
    "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": "1673 BOYER ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LONGWOOD",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32750-6288",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-338-6227",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "600 E DIXIE AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEESBURG",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34748-5925",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-323-5762",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/06/2021",
    "LastUpdateDate": "07/19/2025",
    "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": "367500000X",
        "TaxonomyName": "Certified Registered Nurse Anesthetist",
        "LicenseNumber": "9464143",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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