NPI Code Detail JSON Logo

1659038537 NPI number — OLIVIA PERRAL MAGANN PT

NPI Number: 1659038537
Health Care Provider/Practitioner: OLIVIA PERRAL MAGANN PT

Information about “1659038537” NPI (OLIVIA PERRAL MAGANN PT) exists in 1659038537 in HTML format HTML  |  1659038537 in plain Text format TXT  |  1659038537 in PDF (Portable Document Format) PDF  |  1659038537 in an XML format XML  formats.

NPI Number : 1659038537 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659038537",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MAGANN",
    "FirstName": "OLIVIA",
    "MiddleName": "PERRAL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PERRAL",
    "OtherFirstName": "OLIVIA",
    "OtherMiddleName": "BOHOLST",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "4221 W SPRUCE ST APT 2303",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TAMPA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33607-7245",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "813-407-7773",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1450 VENICE ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VENICE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34292",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "919-424-5080",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/26/2021",
    "LastUpdateDate": "11/26/2021",
    "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": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "PT6754",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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