NPI Code Detail JSON Logo

1669108700 NPI number — VICTOR ENRIQUE EMMANUELLI RODRIGUEZ II PSYD

NPI Number: 1669108700
Health Care Provider/Practitioner: VICTOR ENRIQUE EMMANUELLI RODRIGUEZ II PSYD

Information about “1669108700” NPI (VICTOR ENRIQUE EMMANUELLI RODRIGUEZ II PSYD) exists in 1669108700 in HTML format HTML  |  1669108700 in plain Text format TXT  |  1669108700 in PDF (Portable Document Format) PDF  |  1669108700 in an XML format XML  formats.

NPI Number : 1669108700 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669108700",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EMMANUELLI RODRIGUEZ",
    "FirstName": "VICTOR",
    "MiddleName": "ENRIQUE",
    "NamePrefix": "DR.",
    "NameSuffix": "II",
    "Credential": "PSYD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "ENCANTADA RIO CRISTAL",
    "SecondLineMailingAddress": "RC-30 CALLE VIA DEL RIO",
    "MailingAddressCityName": "TRUJILLO ALTO",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00976-0000",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-310-5843",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "MONTE ATENAS OFFICE PARK",
    "SecondLinePracticeLocationAddress": "SUITE 205",
    "PracticeLocationAddressCityName": "TRUJILLO ALTO",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00926-0000",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-310-5843",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/30/2022",
    "LastUpdateDate": "11/25/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC1900X",
        "TaxonomyName": "Counseling Psychologist",
        "LicenseNumber": "6206",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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