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1245054006 NPI number — ANNA JULIANNA VALLARTA

NPI Number: 1245054006
Health Care Provider/Practitioner: ANNA JULIANNA VALLARTA

Information about “1245054006” NPI (ANNA JULIANNA VALLARTA) exists in 1245054006 in HTML format HTML  |  1245054006 in plain Text format TXT  |  1245054006 in PDF (Portable Document Format) PDF  |  1245054006 in an XML format XML  formats.

NPI Number : 1245054006 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245054006",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "VALLARTA",
    "FirstName": "ANNA",
    "MiddleName": "JULIANNA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "VALLARTA",
    "OtherFirstName": "ALEXANDER",
    "OtherMiddleName": "JOSEPH",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "430 W MUHAMMAD ALI BLVD # 1416",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOUISVILLE",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40202-2349",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "973-998-1139",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "500 S PRESTON ST RM 305",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOUISVILLE",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40202-1702",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "973-998-1139",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/08/2024",
    "LastUpdateDate": "07/01/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "X",
    "Gender": null,
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "390200000X",
        "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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