1275711798 NPI number — MARIA ROWENA DELEON MS, LATC, ATC, PES

NPI Number: 1275711798
Health Care Provider/Practitioner: MARIA ROWENA DELEON MS, LATC, ATC, PES

NPI Number : 1275711798 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275711798",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DELEON",
    "FirstName": "MARIA",
    "MiddleName": "ROWENA",
    "NamePrefix": "MISS",
    "NameSuffix": null,
    "Credential": "MS, LATC, ATC, PES",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2425 BAHIA VISTA ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SARASOTA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34239-2502",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "630-299-6770",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6150 N LOCKWOOD RIDGE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SARASOTA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34243-2527",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "941-960-4741",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/06/2008",
    "LastUpdateDate": "05/05/2017",
    "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": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AL 4430",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "096.002224",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225200000X",
          "TaxonomyName": "Physical Therapy Assistant",
          "LicenseNumber": "PTA 27473",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}