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1972842128 NPI number — JUAN JOSE IBIETATORREMENDIA RPH

NPI Number: 1972842128
Health Care Provider/Practitioner: JUAN JOSE IBIETATORREMENDIA RPH

Information about “1972842128” NPI (JUAN JOSE IBIETATORREMENDIA RPH) exists in 1972842128 in HTML format HTML  |  1972842128 in plain Text format TXT  |  1972842128 in PDF (Portable Document Format) PDF  |  1972842128 in an XML format XML  formats.

NPI Number : 1972842128 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1972842128",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IBIETATORREMENDIA",
    "FirstName": "JUAN",
    "MiddleName": "JOSE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RPH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "937 OBISPO AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORAL GABLES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33134-3645",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "863-233-2781",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "39200 HOOKER HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BELLE GLADE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33430-5368",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-996-6572",
    "PracticeLocationAddressFaxNumber": "561-996-6608",
    "EnumerationDate": "02/07/2013",
    "LastUpdateDate": "10/16/2013",
    "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": "1835P0018X",
        "TaxonomyName": "Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
        "LicenseNumber": "PS45089",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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