1851489066 NPI number — LEE A GIBSTEIN M.D., P.A.

NPI Number: 1851489066
Health Care Provider/Practitioner: LEE A GIBSTEIN M.D., P.A.

NPI Number : 1851489066 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851489066",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GIBSTEIN",
    "FirstName": "LEE",
    "MiddleName": "A",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D., P.A.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1111 KANE CONCOURSE",
    "SecondLineMailingAddress": "SUITE 311",
    "MailingAddressCityName": "BAY HARBOR ISLANDS",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33154-2029",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-865-2802",
    "MailingAddressFaxNumber": "305-865-9257",
    "FirstLinePracticeLocationAddress": "1111 KANE CONCOURSE",
    "SecondLinePracticeLocationAddress": "SUITE 311",
    "PracticeLocationAddressCityName": "BAY HARBOR ISLANDS",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33154-2029",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-865-2802",
    "PracticeLocationAddressFaxNumber": "305-865-9257",
    "EnumerationDate": "10/11/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": "ME0072180",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}