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1770630709 NPI number — LILIAN P OBRERO GINES M.D.

NPI Number: 1770630709
Health Care Provider/Practitioner: LILIAN P OBRERO GINES M.D.

Information about “1770630709” NPI (LILIAN P OBRERO GINES M.D.) exists in 1770630709 in HTML format HTML  |  1770630709 in plain Text format TXT  |  1770630709 in PDF (Portable Document Format) PDF  |  1770630709 in an XML format XML  formats.

NPI Number : 1770630709 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1770630709",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GINES",
    "FirstName": "LILIAN",
    "MiddleName": "P OBRERO",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1600 SHEFFIELD PARK CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32225-2667",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-221-1658",
    "MailingAddressFaxNumber": "904-221-9408",
    "FirstLinePracticeLocationAddress": "9957 MOORINGS DR",
    "SecondLinePracticeLocationAddress": "204",
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32257-2412",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-513-4947",
    "PracticeLocationAddressFaxNumber": "904-513-4948",
    "EnumerationDate": "01/04/2007",
    "LastUpdateDate": "02/26/2016",
    "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": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "ME88628",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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