NPI Code Detail JSON Logo

1336765999 NPI number — JALISA LASHAE CARVALHO MD

NPI Number: 1336765999
Health Care Provider/Practitioner: JALISA LASHAE CARVALHO MD

Information about “1336765999” NPI (JALISA LASHAE CARVALHO MD) exists in 1336765999 in HTML format HTML  |  1336765999 in plain Text format TXT  |  1336765999 in PDF (Portable Document Format) PDF  |  1336765999 in an XML format XML  formats.

NPI Number : 1336765999 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336765999",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CARVALHO",
    "FirstName": "JALISA",
    "MiddleName": "LASHAE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1801 W SAMPLE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DEERFIELD BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33064-1369",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "954-486-4085",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "201 E SAMPLE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DEERFIELD BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33064-3502",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-786-6920",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/19/2020",
    "LastUpdateDate": "11/26/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "01/17/2022",
    "NPIReactivationDate": "07/12/2022",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "ME167371",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RH0002X",
          "TaxonomyName": "Hospice and Palliative Medicine (Internal Medicine) Physician",
          "LicenseNumber": "ME167371",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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