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1164657656 NPI number — ROBIN J WURTH LMT

NPI Number: 1164657656
Health Care Provider/Practitioner: ROBIN J WURTH LMT

Information about “1164657656” NPI (ROBIN J WURTH LMT) exists in 1164657656 in HTML format HTML  |  1164657656 in plain Text format TXT  |  1164657656 in PDF (Portable Document Format) PDF  |  1164657656 in an XML format XML  formats.

NPI Number : 1164657656 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164657656",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WURTH",
    "FirstName": "ROBIN",
    "MiddleName": "J",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10548 SE HIGHWAY 42",
    "SecondLineMailingAddress": "SUITE 1",
    "MailingAddressCityName": "SUMMERFIELD",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34491-6633",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-804-7138",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "920 ROLLING ACRES RD",
    "SecondLinePracticeLocationAddress": "SUITE 1",
    "PracticeLocationAddressCityName": "LADY LAKE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32159-5028",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-804-7138",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/27/2009",
    "LastUpdateDate": "01/06/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "MA 53963",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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