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1124072194 NPI number — ILAN ALHADEFF MD

NPI Number: 1124072194
Health Care Provider/Practitioner: ILAN ALHADEFF MD

Information about “1124072194” NPI (ILAN ALHADEFF MD) exists in 1124072194 in HTML format HTML  |  1124072194 in plain Text format TXT  |  1124072194 in PDF (Portable Document Format) PDF  |  1124072194 in an XML format XML  formats.

NPI Number : 1124072194 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124072194",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ALHADEFF",
    "FirstName": "ILAN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1643 NW 136TH AVE STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUNRISE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33323-2857",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "800-424-3672",
    "MailingAddressFaxNumber": "954-377-3042",
    "FirstLinePracticeLocationAddress": "3501 JOHNSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOLLYWOOD",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33021-5421",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-265-1562",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/22/2006",
    "LastUpdateDate": "03/26/2021",
    "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": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "35.134852",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "MA07934400",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "236677",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "51663",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "ME104650",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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