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1356302202 NPI number — CARMEN D IRIZARRY CEBALLOS MD

NPI Number: 1356302202
Health Care Provider/Practitioner: CARMEN D IRIZARRY CEBALLOS MD

Information about “1356302202” NPI (CARMEN D IRIZARRY CEBALLOS MD) exists in 1356302202 in HTML format HTML  |  1356302202 in plain Text format TXT  |  1356302202 in PDF (Portable Document Format) PDF  |  1356302202 in an XML format XML  formats.

NPI Number : 1356302202 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356302202",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IRIZARRY CEBALLOS",
    "FirstName": "CARMEN",
    "MiddleName": "D",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "G14 VIA CUMBRES",
    "SecondLineMailingAddress": "LA VISTA",
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00924-4475",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-750-8696",
    "MailingAddressFaxNumber": "787-750-8696",
    "FirstLinePracticeLocationAddress": "CELIS AGUILERA 10B",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAJARDO",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00738",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-801-6592",
    "PracticeLocationAddressFaxNumber": "787-863-9080",
    "EnumerationDate": "03/30/2006",
    "LastUpdateDate": "03/17/2017",
    "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": "208D00000X",
        "TaxonomyName": "General Practice Physician",
        "LicenseNumber": "11188",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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