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1174994685 NPI number — ODISSEO INVESTMENT GROUP CORPORATION

NPI Number: 1174994685
Health Care Provider/Practitioner: ODISSEO INVESTMENT GROUP CORPORATION

Information about “1174994685” NPI (ODISSEO INVESTMENT GROUP CORPORATION) exists in 1174994685 in HTML format HTML  |  1174994685 in plain Text format TXT  |  1174994685 in PDF (Portable Document Format) PDF  |  1174994685 in an XML format XML  formats.

NPI Number : 1174994685 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174994685",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ODISSEO INVESTMENT GROUP CORPORATION",
    "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": "1003 CALLE 2 NE",
    "SecondLineMailingAddress": "URB PUERTO NUEVO",
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00920-2534",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1003 CALLE 2 NE",
    "SecondLinePracticeLocationAddress": "SUITE 2 ALTOS",
    "PracticeLocationAddressCityName": "SAN JUAN",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00920-2534",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-404-7576",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/09/2015",
    "LastUpdateDate": "10/09/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ORTIZ",
    "AuthorizedOfficialFirstName": "ULISES",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "787-404-7576",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "335E00000X",
          "TaxonomyName": "Prosthetic/Orthotic Supplier",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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