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1912492588 NPI number — MINDRA ASHLEY PEREZ

NPI Number: 1912492588
Health Care Provider/Practitioner: MINDRA ASHLEY PEREZ

Information about “1912492588” NPI (MINDRA ASHLEY PEREZ) exists in 1912492588 in HTML format HTML  |  1912492588 in plain Text format TXT  |  1912492588 in PDF (Portable Document Format) PDF  |  1912492588 in an XML format XML  formats.

NPI Number : 1912492588 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912492588",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PEREZ",
    "FirstName": "MINDRA",
    "MiddleName": "ASHLEY",
    "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": "PO BOX 1088",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BUNNELL",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32110-1088",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "386-270-2664",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "56 POST VIEW DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALM COAST",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32164-4948",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "386-270-2664",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/26/2018",
    "LastUpdateDate": "06/26/2018",
    "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": "224ZE0001X",
          "TaxonomyName": "Environmental Modification Occupational Therapy Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "224ZF0002X",
          "TaxonomyName": "Feeding, Eating & Swallowing Occupational Therapy Assistant",
          "LicenseNumber": "OTA13611",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "224ZL0004X",
          "TaxonomyName": "Low Vision Occupational Therapy Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "224Z00000X",
          "TaxonomyName": "Occupational Therapy Assistant",
          "LicenseNumber": "OTA13611",
          "LicenseNumberStateCode": "FL",
          "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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