NPI Code Detail JSON Logo

1255800496 NPI number — LUIS ERNESTO CEBALLOS

NPI Number: 1255800496
Health Care Provider/Practitioner: LUIS ERNESTO CEBALLOS

Information about “1255800496” NPI (LUIS ERNESTO CEBALLOS) exists in 1255800496 in HTML format HTML  |  1255800496 in plain Text format TXT  |  1255800496 in PDF (Portable Document Format) PDF  |  1255800496 in an XML format XML  formats.

NPI Number : 1255800496 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255800496",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CEBALLOS",
    "FirstName": "LUIS",
    "MiddleName": "ERNESTO",
    "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": "15043 SW 109TH LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIAMI",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33196-2531",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-495-2565",
    "MailingAddressFaxNumber": "786-364-1676",
    "FirstLinePracticeLocationAddress": "9260 HAMMOCKS BLVD STE 202",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIAMI",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33196-1584",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-353-2900",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/16/2018",
    "LastUpdateDate": "11/16/2018",
    "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": "106S00000X",
        "TaxonomyName": "Behavior Technician",
        "LicenseNumber": "RBT-18-69497",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.