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1790719847 NPI number — LINDA M FITZGERALD RPT

NPI Number: 1790719847
Health Care Provider/Practitioner: LINDA M FITZGERALD RPT

Information about “1790719847” NPI (LINDA M FITZGERALD RPT) exists in 1790719847 in HTML format HTML  |  1790719847 in plain Text format TXT  |  1790719847 in PDF (Portable Document Format) PDF  |  1790719847 in an XML format XML  formats.

NPI Number : 1790719847 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790719847",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FITZGERALD",
    "FirstName": "LINDA",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MIDNIGHT",
    "OtherFirstName": "LINDA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "RPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "PO BOX 35380",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89133-5380",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "23595 MOULTON PKWY STE E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAGUNA HILLS",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92653-1939",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "949-218-0853",
    "PracticeLocationAddressFaxNumber": "949-218-0856",
    "EnumerationDate": "07/11/2006",
    "LastUpdateDate": "08/07/2025",
    "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": "194144",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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