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1245886480 NPI number — YAMILEYDI PENA MAREY

NPI Number: 1245886480
Health Care Provider/Practitioner: YAMILEYDI PENA MAREY

Information about “1245886480” NPI (YAMILEYDI PENA MAREY) exists in 1245886480 in HTML format HTML  |  1245886480 in plain Text format TXT  |  1245886480 in PDF (Portable Document Format) PDF  |  1245886480 in an XML format XML  formats.

NPI Number : 1245886480 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1245886480",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PENA MAREY",
    "FirstName": "YAMILEYDI",
    "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": "1438 FOXBORO DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRANDON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33511-6256",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-833-8210",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "14001 VILLAGE TERRACE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TAMPA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33624-6900",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-833-8210",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/13/2019",
    "LastUpdateDate": "01/24/2024",
    "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": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": "1-24-70852",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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