NPI Code Detail JSON Logo

1902102734 NPI number — TRAVELING DOC INC.

NPI Number: 1902102734
Health Care Provider/Practitioner: TRAVELING DOC INC.

Information about “1902102734” NPI (TRAVELING DOC INC.) exists in 1902102734 in HTML format HTML  |  1902102734 in plain Text format TXT  |  1902102734 in PDF (Portable Document Format) PDF  |  1902102734 in an XML format XML  formats.

NPI Number : 1902102734 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1902102734",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TRAVELING DOC INC.",
    "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": "1904 S CICERO AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CICERO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60804-2545",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "855-484-7362",
    "MailingAddressFaxNumber": "708-863-7213",
    "FirstLinePracticeLocationAddress": "1904 S CICERO AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CICERO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60804-2545",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "855-484-7362",
    "PracticeLocationAddressFaxNumber": "708-863-7213",
    "EnumerationDate": "01/26/2011",
    "LastUpdateDate": "01/26/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GONZALEZ",
    "AuthorizedOfficialFirstName": "CARLOS",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": "JR.",
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "561-624-5347",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "208D00000X",
        "TaxonomyName": "General Practice Physician",
        "LicenseNumber": "036.127046",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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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