1669920880 NPI number — DANIEL V MOCK MSN, APRN, AGACNP-BC

NPI Number: 1669920880
Health Care Provider/Practitioner: DANIEL V MOCK MSN, APRN, AGACNP-BC

NPI Number : 1669920880 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669920880",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MOCK",
    "FirstName": "DANIEL",
    "MiddleName": "V",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "MSN, APRN, AGACNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "15954 SW 4TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEMBROKE PINES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33027-1156",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7100 W 20TH AVE STE G176",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HIALEAH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33016-1875",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-475-1985",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/16/2016",
    "LastUpdateDate": "03/07/2025",
    "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": "363LG0600X",
          "TaxonomyName": "Gerontology Nurse Practitioner",
          "LicenseNumber": "ARNP9311528",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LA2100X",
          "TaxonomyName": "Acute Care Nurse Practitioner",
          "LicenseNumber": "ARNP9311528",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}