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1609727544 NPI number — CAMBIOS EN VIDA HEALTH MANAGEMENT LLC

NPI Number: 1609727544
Health Care Provider/Practitioner: CAMBIOS EN VIDA HEALTH MANAGEMENT LLC

Information about “1609727544” NPI (CAMBIOS EN VIDA HEALTH MANAGEMENT LLC) exists in 1609727544 in HTML format HTML  |  1609727544 in plain Text format TXT  |  1609727544 in PDF (Portable Document Format) PDF  |  1609727544 in an XML format XML  formats.

NPI Number : 1609727544 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609727544",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CAMBIOS EN VIDA HEALTH MANAGEMENT LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1050 AVE LAS PALMAS # L-4",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN JUAN",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00907-5220",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "939-588-0326",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1050 AVE LAS PALMAS # L-4",
    "SecondLinePracticeLocationAddress": "CONDOMINIO PUERTA DE LA BAHIA",
    "PracticeLocationAddressCityName": "SAN JUAN",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00907-5220",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "939-588-0326",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/06/2026",
    "LastUpdateDate": "02/06/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BONILLA",
    "AuthorizedOfficialFirstName": "GABRIEL",
    "AuthorizedOfficialMiddleName": "ENRIQUE",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "787-204-8378",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM1300X",
          "TaxonomyName": "Multi-Specialty Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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