NPI Code Detail JSON Logo

1710347349 NPI number — SOLSTICE MEDICINE & WELLNESS, LLC

NPI Number: 1710347349
Health Care Provider/Practitioner: SOLSTICE MEDICINE & WELLNESS, LLC

Information about “1710347349” NPI (SOLSTICE MEDICINE & WELLNESS, LLC) exists in 1710347349 in HTML format HTML  |  1710347349 in plain Text format TXT  |  1710347349 in PDF (Portable Document Format) PDF  |  1710347349 in an XML format XML  formats.

NPI Number : 1710347349 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710347349",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOLSTICE MEDICINE & WELLNESS, 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": "3875 GEIST RD STE E154",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAIRBANKS",
    "MailingAddressStateName": "AK",
    "MailingAddressPostalCode": "99709-3564",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "907-456-6334",
    "MailingAddressFaxNumber": "907-456-6336",
    "FirstLinePracticeLocationAddress": "475 RIVERSTONE WAY STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAIRBANKS",
    "PracticeLocationAddressStateName": "AK",
    "PracticeLocationAddressPostalCode": "99709-2971",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "907-456-6334",
    "PracticeLocationAddressFaxNumber": "907-456-6336",
    "EnumerationDate": "02/24/2016",
    "LastUpdateDate": "04/26/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ESCOBAR",
    "AuthorizedOfficialFirstName": "GINA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "907-978-5733",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM2500X",
          "TaxonomyName": "Medical Specialty Clinic/Center",
          "LicenseNumber": "1032552",
          "LicenseNumberStateCode": "AK",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.