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1598427130 NPI number — CENTRO DE SALUD FAMILIAR NORCROSS MEDICAL CLINIC LLC

NPI Number: 1598427130
Health Care Provider/Practitioner: CENTRO DE SALUD FAMILIAR NORCROSS MEDICAL CLINIC LLC

Information about “1598427130” NPI (CENTRO DE SALUD FAMILIAR NORCROSS MEDICAL CLINIC LLC) exists in 1598427130 in HTML format HTML  |  1598427130 in plain Text format TXT  |  1598427130 in PDF (Portable Document Format) PDF  |  1598427130 in an XML format XML  formats.

NPI Number : 1598427130 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598427130",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CENTRO DE SALUD FAMILIAR NORCROSS MEDICAL CLINIC LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5717 ALLEE WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BRASELTON",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30517-6200",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "678-333-3498",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5836 BUFORD HWY STE C",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORCROSS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30071-2581",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-734-9920",
    "PracticeLocationAddressFaxNumber": "770-734-9115",
    "EnumerationDate": "10/11/2021",
    "LastUpdateDate": "01/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PARRA",
    "AuthorizedOfficialFirstName": "RODRIGO",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER, CFO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "678-333-3498",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP0904X",
        "TaxonomyName": "Federal Public Health Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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