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1497563498 NPI number — ISABELLE KAYDEN FUSARO

NPI Number: 1497563498
Health Care Provider/Practitioner: ISABELLE KAYDEN FUSARO

Information about “1497563498” NPI (ISABELLE KAYDEN FUSARO) exists in 1497563498 in HTML format HTML  |  1497563498 in plain Text format TXT  |  1497563498 in PDF (Portable Document Format) PDF  |  1497563498 in an XML format XML  formats.

NPI Number : 1497563498 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1497563498",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FUSARO",
    "FirstName": "ISABELLE",
    "MiddleName": "KAYDEN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KIESTER-FUSARO",
    "OtherFirstName": "ISABELLE",
    "OtherMiddleName": "PERRA",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "101 RIVERFRONT BLVD STE 710",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRADENTON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34205-8812",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "941-776-4000",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1110 E GIBSON ST BLDG A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ARCADIA",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34266-5011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "863-494-4433",
    "PracticeLocationAddressFaxNumber": "863-993-0119",
    "EnumerationDate": "12/21/2024",
    "LastUpdateDate": "04/01/2025",
    "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": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": "PA9119722",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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