1275892309 NPI number — VICTOR L. HERRERA, D.P.M., P.A

NPI Number: 1275892309
Health Care Provider/Practitioner: VICTOR L. HERRERA, D.P.M., P.A

NPI Number : 1275892309 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1275892309",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "VICTOR L. HERRERA, D.P.M., P.A",
    "ParentOrgTIN": null,
    "OrgName": "VICTOR L. HERRERA, D.P.M., P.A",
    "LastName": null,
    "FirstName": null,
    "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": "4980 PALM AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HIALEAH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33012-3726",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-512-0080",
    "MailingAddressFaxNumber": "305-512-0082",
    "FirstLinePracticeLocationAddress": "4980 PALM AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HIALEAH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33012-3726",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-512-0080",
    "PracticeLocationAddressFaxNumber": "305-512-0082",
    "EnumerationDate": "05/09/2012",
    "LastUpdateDate": "05/09/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HERRERA",
    "AuthorizedOfficialFirstName": "VICTOR",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "305-773-5096",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QA1903X",
          "TaxonomyName": "Ambulatory Surgical Clinic/Center",
          "LicenseNumber": "PO3517",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0200X",
          "TaxonomyName": "Radiology Clinic/Center",
          "LicenseNumber": "PO3517",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": "PO3517",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}