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1164220125 NPI number — SANITAS OCOEE IDTC

NPI Number: 1164220125
Health Care Provider/Practitioner: SANITAS OCOEE IDTC

Information about “1164220125” NPI (SANITAS OCOEE IDTC) exists in 1164220125 in HTML format HTML  |  1164220125 in plain Text format TXT  |  1164220125 in PDF (Portable Document Format) PDF  |  1164220125 in an XML format XML  formats.

NPI Number : 1164220125 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164220125",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SANITAS OCOEE IDTC",
    "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": "8400 NW 33RD ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DORAL",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33122-2008",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8849 W COLONIAL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "OCOEE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34761-6951",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-926-1245",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/05/2025",
    "LastUpdateDate": "03/05/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "TORRES",
    "AuthorizedOfficialFirstName": "MAYRA",
    "AuthorizedOfficialMiddleName": "G",
    "AuthorizedOfficialTitle": "CFO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "718-918-2370",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QR0200X",
        "TaxonomyName": "Radiology Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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