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1740239177 NPI number — MICHELLE PEARL FITZGERALD P.T

NPI Number: 1740239177
Health Care Provider/Practitioner: MICHELLE PEARL FITZGERALD P.T

Information about “1740239177” NPI (MICHELLE PEARL FITZGERALD P.T) exists in 1740239177 in HTML format HTML  |  1740239177 in plain Text format TXT  |  1740239177 in PDF (Portable Document Format) PDF  |  1740239177 in an XML format XML  formats.

NPI Number : 1740239177 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740239177",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FITZGERALD",
    "FirstName": "MICHELLE",
    "MiddleName": "PEARL",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P.T",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1313 ST TROPEZ CIR",
    "SecondLineMailingAddress": "APT 1510",
    "MailingAddressCityName": "WESTON",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33326-3007",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "303-918-4147",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2950 CLEVELAND CLINIC BLVD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WESTON",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33331-3609",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "303-918-4147",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/10/2006",
    "LastUpdateDate": "09/23/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": "26454",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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