NPI Code Detail JSON Logo

1164823589 NPI number — REBECCA DOROTHY RUDOFF B.A.

NPI Number: 1164823589
Health Care Provider/Practitioner: REBECCA DOROTHY RUDOFF B.A.

Information about “1164823589” NPI (REBECCA DOROTHY RUDOFF B.A.) exists in 1164823589 in HTML format HTML  |  1164823589 in plain Text format TXT  |  1164823589 in PDF (Portable Document Format) PDF  |  1164823589 in an XML format XML  formats.

NPI Number : 1164823589 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164823589",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUDOFF",
    "FirstName": "REBECCA",
    "MiddleName": "DOROTHY",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "B.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RUDOFF",
    "OtherFirstName": "REBECCA",
    "OtherMiddleName": "DOROTHY",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "B.A.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "2814 S US HIGHWAY 1 STE D4",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FORT PIERCE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34982-8110",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "772-979-1135",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2814 S US HIGHWAY 1 STE D4",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT PIERCE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34982-8110",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "772-979-1135",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/05/2014",
    "LastUpdateDate": "09/05/2014",
    "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": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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