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1912394537 NPI number — ALLIANCE FOUNDATION OF FLORIDA-INDIGO MANOR, LLC

NPI Number: 1912394537
Health Care Provider/Practitioner: ALLIANCE FOUNDATION OF FLORIDA-INDIGO MANOR, LLC

Information about “1912394537” NPI (ALLIANCE FOUNDATION OF FLORIDA-INDIGO MANOR, LLC) exists in 1912394537 in HTML format HTML  |  1912394537 in plain Text format TXT  |  1912394537 in PDF (Portable Document Format) PDF  |  1912394537 in an XML format XML  formats.

NPI Number : 1912394537 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912394537",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "ALLIANCE FOUNDATION OF FLORIDA, INC",
    "ParentOrgTIN": null,
    "OrgName": "ALLIANCE FOUNDATION OF FLORIDA-INDIGO MANOR, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "148 CYPRESS POINT PKWY SUITE 208",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM COAST",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32164-8426",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "386-225-4700",
    "MailingAddressFaxNumber": "386-225-4627",
    "FirstLinePracticeLocationAddress": "145 CYPRESS POINT PKWY",
    "SecondLinePracticeLocationAddress": "SUITE 208",
    "PracticeLocationAddressCityName": "PALM COAST",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32164-8426",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "386-225-4700",
    "PracticeLocationAddressFaxNumber": "386-225-4627",
    "EnumerationDate": "04/21/2015",
    "LastUpdateDate": "04/21/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "TOWNSEND",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VICE PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "386-225-4700",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "332B00000X",
        "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
        "LicenseNumber": "1314098",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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