NPI Code Detail JSON Logo

1164293445 NPI number — INNOVISTA TECH SOLUTIONS LLC

NPI Number: 1164293445
Health Care Provider/Practitioner: INNOVISTA TECH SOLUTIONS LLC

Information about “1164293445” NPI (INNOVISTA TECH SOLUTIONS LLC) exists in 1164293445 in HTML format HTML  |  1164293445 in plain Text format TXT  |  1164293445 in PDF (Portable Document Format) PDF  |  1164293445 in an XML format XML  formats.

NPI Number : 1164293445 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164293445",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "INNOVISTA TECH SOLUTIONS 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": "9700 S CENTRAL AVE UNIT 221",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHOENIX",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85042-8398",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-491-5489",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7221 S 53RD LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAVEEN",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85339-6963",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-491-5489",
    "PracticeLocationAddressFaxNumber": "623-246-7060",
    "EnumerationDate": "01/15/2024",
    "LastUpdateDate": "10/08/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ABDELRAZIG",
    "AuthorizedOfficialFirstName": "ASHRAF",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "602-491-5489",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235500000X",
        "TaxonomyName": "Speech/Language/Hearing Specialist/Technologist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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