NPI Code Detail JSON Logo

1306368386 NPI number — SUSAN R CROSS M.S., LATC

NPI Number: 1306368386
Health Care Provider/Practitioner: SUSAN R CROSS M.S., LATC

Information about “1306368386” NPI (SUSAN R CROSS M.S., LATC) exists in 1306368386 in HTML format HTML  |  1306368386 in plain Text format TXT  |  1306368386 in PDF (Portable Document Format) PDF  |  1306368386 in an XML format XML  formats.

NPI Number : 1306368386 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1306368386",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CROSS",
    "FirstName": "SUSAN",
    "MiddleName": "R",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.S., LATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "33701 ST RD 52",
    "SecondLineMailingAddress": "MSC 2038",
    "MailingAddressCityName": "SAINT LEO",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33603",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "33701 ST RD 52",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAINT LEO",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33574",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-588-7557",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/12/2017",
    "LastUpdateDate": "07/12/2017",
    "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": "FL3905",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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