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1730409814 NPI number — WAYPOINT MEDICAL LLC

NPI Number: 1730409814
Health Care Provider/Practitioner: WAYPOINT MEDICAL LLC

Information about “1730409814” NPI (WAYPOINT MEDICAL LLC) exists in 1730409814 in HTML format HTML  |  1730409814 in plain Text format TXT  |  1730409814 in PDF (Portable Document Format) PDF  |  1730409814 in an XML format XML  formats.

NPI Number : 1730409814 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730409814",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "WAYPOINT MEDICAL LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1001 S RIVERSIDE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EDGEWATER",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32132-2348",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "386-690-4382",
    "MailingAddressFaxNumber": "386-423-9944",
    "FirstLinePracticeLocationAddress": "500 N WASHINGTON AVE STE 108",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TITUSVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32796-2759",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "386-690-4382",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/11/2010",
    "LastUpdateDate": "10/19/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MOYLE",
    "AuthorizedOfficialFirstName": "JAMES",
    "AuthorizedOfficialMiddleName": "RILEY",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "386-690-4382",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251E00000X",
        "TaxonomyName": "Home Health Agency",
        "LicenseNumber": "PENDING APPROVAL",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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