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1174969588 NPI number — MS. ANNETTE ANGELA THOMAS

NPI Number: 1174969588
Health Care Provider/Practitioner: MS. ANNETTE ANGELA THOMAS

Information about “1174969588” NPI (MS. ANNETTE ANGELA THOMAS) exists in 1174969588 in HTML format HTML  |  1174969588 in plain Text format TXT  |  1174969588 in PDF (Portable Document Format) PDF  |  1174969588 in an XML format XML  formats.

NPI Number : 1174969588 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174969588",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "THOMAS",
    "FirstName": "ANNETTE",
    "MiddleName": "ANGELA",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "18520 SATSUMA AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORT CHARLOTTE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33948-7520",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "941-625-8264",
    "MailingAddressFaxNumber": "941-625-8264",
    "FirstLinePracticeLocationAddress": "18520 SATSUMA AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORT CHARLOTTE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33948-7520",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "941-625-8264",
    "PracticeLocationAddressFaxNumber": "941-625-8264",
    "EnumerationDate": "05/13/2013",
    "LastUpdateDate": "09/15/2022",
    "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": "311ZA0620X",
        "TaxonomyName": "Adult Care Home Facility",
        "LicenseNumber": "6906610",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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