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1972116929 NPI number — MR. RENATO LUCAS GERONA NAVARRO-SCHLEGEL

NPI Number: 1972116929
Health Care Provider/Practitioner: MR. RENATO LUCAS GERONA NAVARRO-SCHLEGEL

Information about “1972116929” NPI (MR. RENATO LUCAS GERONA NAVARRO-SCHLEGEL) exists in 1972116929 in HTML format HTML  |  1972116929 in plain Text format TXT  |  1972116929 in PDF (Portable Document Format) PDF  |  1972116929 in an XML format XML  formats.

NPI Number : 1972116929 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972116929",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NAVARRO-SCHLEGEL",
    "FirstName": "RENATO LUCAS",
    "MiddleName": "GERONA",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3480 SEGO GLEN CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAS VEGAS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89121-3809",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "323-603-6552",
    "MailingAddressFaxNumber": "702-665-4251",
    "FirstLinePracticeLocationAddress": "4221 MCLEOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAS VEGAS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89121-5215",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "702-474-6450",
    "PracticeLocationAddressFaxNumber": "702-665-4251",
    "EnumerationDate": "08/28/2020",
    "LastUpdateDate": "08/28/2020",
    "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": "175T00000X",
        "TaxonomyName": "Peer Specialist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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