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1851258776 NPI number — FOUNDATIONS HEALTH CENTERS

NPI Number: 1851258776
Health Care Provider/Practitioner: FOUNDATIONS HEALTH CENTERS

Information about “1851258776” NPI (FOUNDATIONS HEALTH CENTERS) exists in 1851258776 in HTML format HTML  |  1851258776 in plain Text format TXT  |  1851258776 in PDF (Portable Document Format) PDF  |  1851258776 in an XML format XML  formats.

NPI Number : 1851258776 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851258776",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FOUNDATIONS HEALTH CENTERS",
    "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": "1501 ROBERT J CONLAN BLVD NE STE 7",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM BAY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32905-3559",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "321-479-4083",
    "MailingAddressFaxNumber": "321-294-5036",
    "FirstLinePracticeLocationAddress": "1501 ROBERT J CONLAN BLVD NE STE 7",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALM BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32905-3559",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "321-479-4083",
    "PracticeLocationAddressFaxNumber": "321-294-5036",
    "EnumerationDate": "01/05/2026",
    "LastUpdateDate": "01/05/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DICKUN",
    "AuthorizedOfficialFirstName": "CHRISTAL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER, CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "860-204-1200",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2083A0300X",
        "TaxonomyName": "Addiction Medicine (Preventive Medicine) Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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