NPI Code Detail JSON Logo

1144452582 NPI number — OP MEDICAL LLC

NPI Number: 1144452582
Health Care Provider/Practitioner: OP MEDICAL LLC

Information about “1144452582” NPI (OP MEDICAL LLC) exists in 1144452582 in HTML format HTML  |  1144452582 in plain Text format TXT  |  1144452582 in PDF (Portable Document Format) PDF  |  1144452582 in an XML format XML  formats.

NPI Number : 1144452582 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144452582",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OP MEDICAL LLC",
    "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": "1515 HERBERT ST",
    "SecondLineMailingAddress": "STE 209",
    "MailingAddressCityName": "PORT ORANGE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32129-6104",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "386-366-9119",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1515 HERBERT ST",
    "SecondLinePracticeLocationAddress": "STE 209",
    "PracticeLocationAddressCityName": "PORT ORANGE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32129-6104",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "386-366-9119",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/19/2009",
    "LastUpdateDate": "08/19/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "OTTAVIANI",
    "AuthorizedOfficialFirstName": "ANDREW",
    "AuthorizedOfficialMiddleName": "JOSEPH",
    "AuthorizedOfficialTitle": "CLINIC DIRECTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "386-366-9119",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208VP0014X",
        "TaxonomyName": "Interventional Pain Medicine Physician",
        "LicenseNumber": "ME0067232",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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