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1790612885 NPI number — ETTHELIUS HEALTHCARE MANAGEMENT LLC

NPI Number: 1790612885
Health Care Provider/Practitioner: ETTHELIUS HEALTHCARE MANAGEMENT LLC

Information about “1790612885” NPI (ETTHELIUS HEALTHCARE MANAGEMENT LLC) exists in 1790612885 in HTML format HTML  |  1790612885 in plain Text format TXT  |  1790612885 in PDF (Portable Document Format) PDF  |  1790612885 in an XML format XML  formats.

NPI Number : 1790612885 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790612885",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ETTHELIUS HEALTHCARE MANAGEMENT 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": "URB. PERLA DEL SUR CALLE PASEO DEL SUR 2433 LOCAL 1",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PONCE",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00716",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "URB. PERLA DEL SUR CALLE PASEO DEL SUR 2433 LOCAL 1",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PONCE",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00716",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "939-217-2022",
    "PracticeLocationAddressFaxNumber": "787-651-3343",
    "EnumerationDate": "05/05/2026",
    "LastUpdateDate": "05/05/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CASTRERO CORREA",
    "AuthorizedOfficialFirstName": "JEAN",
    "AuthorizedOfficialMiddleName": "C",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LIC",
    "AuthorizedOfficialTelephoneNumber": "939-759-3503",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251B00000X",
        "TaxonomyName": "Case Management Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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