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1215013347 NPI number — IMELIZA FERNANDEZ AVIGLIANO MS, PA-C

NPI Number: 1215013347
Health Care Provider/Practitioner: IMELIZA FERNANDEZ AVIGLIANO MS, PA-C

Information about “1215013347” NPI (IMELIZA FERNANDEZ AVIGLIANO MS, PA-C) exists in 1215013347 in HTML format HTML  |  1215013347 in plain Text format TXT  |  1215013347 in PDF (Portable Document Format) PDF  |  1215013347 in an XML format XML  formats.

NPI Number : 1215013347 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215013347",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "AVIGLIANO",
    "FirstName": "IMELIZA",
    "MiddleName": "FERNANDEZ",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS, PA-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FERNANDEZ",
    "OtherFirstName": "IMELIZA",
    "OtherMiddleName": "MIRADOR",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "MS,PA-C",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5936 LIMESTONE RD",
    "SecondLineMailingAddress": "SUITE 202",
    "MailingAddressCityName": "HOCKESSIN",
    "MailingAddressStateName": "DE",
    "MailingAddressPostalCode": "19707-8930",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "302-239-4500",
    "MailingAddressFaxNumber": "302-489-5000",
    "FirstLinePracticeLocationAddress": "5936 LIMESTONE RD",
    "SecondLinePracticeLocationAddress": "SUITE 202",
    "PracticeLocationAddressCityName": "HOCKESSIN",
    "PracticeLocationAddressStateName": "DE",
    "PracticeLocationAddressPostalCode": "19707-8930",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "302-239-4500",
    "PracticeLocationAddressFaxNumber": "302-489-5000",
    "EnumerationDate": "10/31/2006",
    "LastUpdateDate": "12/13/2016",
    "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": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "C5-0000536",
        "LicenseNumberStateCode": "DE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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