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1508002395 NPI number — YESENIA E JUSTINIANO ROSARIO M.D.

NPI Number: 1508002395
Health Care Provider/Practitioner: YESENIA E JUSTINIANO ROSARIO M.D.

Information about “1508002395” NPI (YESENIA E JUSTINIANO ROSARIO M.D.) exists in 1508002395 in HTML format HTML  |  1508002395 in plain Text format TXT  |  1508002395 in PDF (Portable Document Format) PDF  |  1508002395 in an XML format XML  formats.

NPI Number : 1508002395 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508002395",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JUSTINIANO ROSARIO",
    "FirstName": "YESENIA",
    "MiddleName": "E",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "48 ZEBULAHS TRL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM COAST",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32164-5260",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-317-7792",
    "MailingAddressFaxNumber": "787-831-3270",
    "FirstLinePracticeLocationAddress": "6 SAINT JOHNS MEDICAL PARK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ST AUGUSTINE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32086-5298",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-823-3301",
    "PracticeLocationAddressFaxNumber": "904-823-3328",
    "EnumerationDate": "12/28/2008",
    "LastUpdateDate": "11/14/2024",
    "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": "17382",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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