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1083858203 NPI number — JOHN C EUSTACE, MD, PA

NPI Number: 1083858203
Health Care Provider/Practitioner: JOHN C EUSTACE, MD, PA

Information about “1083858203” NPI (JOHN C EUSTACE, MD, PA) exists in 1083858203 in HTML format HTML  |  1083858203 in plain Text format TXT  |  1083858203 in PDF (Portable Document Format) PDF  |  1083858203 in an XML format XML  formats.

NPI Number : 1083858203 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1083858203",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "JOHN C EUSTACE, MD, PA",
    "LastName": null,
    "FirstName": null,
    "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": "9000 SW 87TH CT",
    "SecondLineMailingAddress": "SUITE 103",
    "MailingAddressCityName": "MIAMI",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33176-2231",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-273-7772",
    "MailingAddressFaxNumber": "305-273-7292",
    "FirstLinePracticeLocationAddress": "9000 SW 87TH CT",
    "SecondLinePracticeLocationAddress": "SUITE 103",
    "PracticeLocationAddressCityName": "MIAMI",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33176-2231",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-273-7772",
    "PracticeLocationAddressFaxNumber": "305-273-7292",
    "EnumerationDate": "05/01/2009",
    "LastUpdateDate": "05/01/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "EUSTACE",
    "AuthorizedOfficialFirstName": "JUDITH",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "BILLING MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "305-273-7772",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207RA0401X",
        "TaxonomyName": "Addiction Medicine (Internal Medicine) Physician",
        "LicenseNumber": "ME26900",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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