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1144384256 NPI number — ROSA M. HEREDIA CASTILLO

NPI Number: 1144384256
Health Care Provider/Practitioner: ROSA M. HEREDIA CASTILLO

Information about “1144384256” NPI (ROSA M. HEREDIA CASTILLO) exists in 1144384256 in HTML format HTML  |  1144384256 in plain Text format TXT  |  1144384256 in PDF (Portable Document Format) PDF  |  1144384256 in an XML format XML  formats.

NPI Number : 1144384256 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144384256",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ROSA M. HEREDIA CASTILLO",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 367331",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00936-7331",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-722-0341",
    "MailingAddressFaxNumber": "787-722-0341",
    "FirstLinePracticeLocationAddress": "260 AVE DE LA CONSTITUCION",
    "SecondLinePracticeLocationAddress": "SUITE 101",
    "PracticeLocationAddressCityName": "SAN JUAN",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00901-2298",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-722-0341",
    "PracticeLocationAddressFaxNumber": "787-722-0341",
    "EnumerationDate": "12/21/2006",
    "LastUpdateDate": "05/30/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HEREDIA",
    "AuthorizedOfficialFirstName": "ROSA",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MT",
    "AuthorizedOfficialTelephoneNumber": "787-722-0341",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": "768",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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