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1700820537 NPI number — MANUEL PUBILLONES MD

NPI Number: 1700820537
Health Care Provider/Practitioner: MANUEL PUBILLONES MD

Information about “1700820537” NPI (MANUEL PUBILLONES MD) exists in 1700820537 in HTML format HTML  |  1700820537 in plain Text format TXT  |  1700820537 in PDF (Portable Document Format) PDF  |  1700820537 in an XML format XML  formats.

NPI Number : 1700820537 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700820537",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PUBILLONES",
    "FirstName": "MANUEL",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3550 GALT OCEAN DR",
    "SecondLineMailingAddress": "APT 807",
    "MailingAddressCityName": "FORT LAUDERDALE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33308-6848",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-212-1254",
    "MailingAddressFaxNumber": "954-433-6008",
    "FirstLinePracticeLocationAddress": "U3-4 CARR 21",
    "SecondLinePracticeLocationAddress": "LAS LOMAS",
    "PracticeLocationAddressCityName": "SAN JUAN",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00921-3313",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-783-3440",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/15/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "2084P0800X",
        "TaxonomyName": "Psychiatry Physician",
        "LicenseNumber": "8887",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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