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1265116461 NPI number — STEPHANIE MONIQUE CORBO FNP-C

NPI Number: 1265116461
Health Care Provider/Practitioner: STEPHANIE MONIQUE CORBO FNP-C

Information about “1265116461” NPI (STEPHANIE MONIQUE CORBO FNP-C) exists in 1265116461 in HTML format HTML  |  1265116461 in plain Text format TXT  |  1265116461 in PDF (Portable Document Format) PDF  |  1265116461 in an XML format XML  formats.

NPI Number : 1265116461 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265116461",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CORBO",
    "FirstName": "STEPHANIE",
    "MiddleName": "MONIQUE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "FNP-C",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "10450 NW 20TH CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SUNRISE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33322-3521",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-226-2679",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15814 W STATE ROAD 84",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SUNRISE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33326-1227",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-715-2997",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/09/2023",
    "LastUpdateDate": "06/09/2023",
    "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": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "APRN11026800",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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