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1184260283 NPI number — MICHAEL RUDELLI MD

NPI Number: 1184260283
Health Care Provider/Practitioner: MICHAEL RUDELLI MD

Information about “1184260283” NPI (MICHAEL RUDELLI MD) exists in 1184260283 in HTML format HTML  |  1184260283 in plain Text format TXT  |  1184260283 in PDF (Portable Document Format) PDF  |  1184260283 in an XML format XML  formats.

NPI Number : 1184260283 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184260283",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUDELLI",
    "FirstName": "MICHAEL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "14690 SPRING HILL DR STE 305",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRING HILL",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34609-8102",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-277-5348",
    "MailingAddressFaxNumber": "352-606-2857",
    "FirstLinePracticeLocationAddress": "5350 SPRING HILL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPRING HILL",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34606-4562",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-277-5378",
    "PracticeLocationAddressFaxNumber": "352-515-6891",
    "EnumerationDate": "11/23/2019",
    "LastUpdateDate": "02/18/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": "21603",
          "LicenseNumberStateCode": "PR",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208D00000X",
          "TaxonomyName": "General Practice Physician",
          "LicenseNumber": "ACN1221",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208M00000X",
          "TaxonomyName": "Hospitalist Physician",
          "LicenseNumber": "ACN1221",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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