NPI Code Detail JSON Logo

1205169919 NPI number — JILL LOVELY PT, DPT

NPI Number: 1205169919
Health Care Provider/Practitioner: JILL LOVELY PT, DPT

Information about “1205169919” NPI (JILL LOVELY PT, DPT) exists in 1205169919 in HTML format HTML  |  1205169919 in plain Text format TXT  |  1205169919 in PDF (Portable Document Format) PDF  |  1205169919 in an XML format XML  formats.

NPI Number : 1205169919 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205169919",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LOVELY",
    "FirstName": "JILL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT, DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "545 FAIRHAVEN DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DAVENPORT",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33837-4555",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4900 MILLENIA BLVD",
    "SecondLinePracticeLocationAddress": "# B",
    "PracticeLocationAddressCityName": "ORLANDO",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32839-6051",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-363-3651",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/13/2009",
    "LastUpdateDate": "09/13/2009",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "PT23509",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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