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1093603458 NPI number — LUCIANA TAKATA PONTES ARRUDA MD, MSC

NPI Number: 1093603458
Health Care Provider/Practitioner: LUCIANA TAKATA PONTES ARRUDA MD, MSC

Information about “1093603458” NPI (LUCIANA TAKATA PONTES ARRUDA MD, MSC) exists in 1093603458 in HTML format HTML  |  1093603458 in plain Text format TXT  |  1093603458 in PDF (Portable Document Format) PDF  |  1093603458 in an XML format XML  formats.

NPI Number : 1093603458 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1093603458",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TAKATA PONTES ARRUDA",
    "FirstName": "LUCIANA",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD, MSC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TAKATA",
    "OtherFirstName": "LUCIANA",
    "OtherMiddleName": null,
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "MD, MSC",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "PO BOX 919832",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ORLANDO",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32891-9832",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "561-748-0510",
    "MailingAddressFaxNumber": "561-748-0598",
    "FirstLinePracticeLocationAddress": "2101 S US HIGHWAY 1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JUPITER",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33477-7321",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-748-0510",
    "PracticeLocationAddressFaxNumber": "561-748-0598",
    "EnumerationDate": "06/25/2025",
    "LastUpdateDate": "07/28/2025",
    "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": "207N00000X",
          "TaxonomyName": "Dermatology Physician",
          "LicenseNumber": "ME175350",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207ND0101X",
          "TaxonomyName": "MOHS-Micrographic Surgery Physician",
          "LicenseNumber": "ME175350",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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