| NPI |
1316124910 |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Entity Type Code |
2 |
The first name of the provider, if the provider
is an individual. |
| Employer Identification Number EIN |
|
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
| Provider Organization Name Legal Business Name |
VERITAS PLC, PA |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
| Provider First Line Business Practice Location Address |
498 PALM SPRINGS DR |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
| Provider Second Line Business Practice Location Address |
SUITE 100 OFFICE #42 |
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot
include a Post Office box. |
| Provider Business Practice Location Address City Name |
ALTAMONTE SPRINGS |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address State Name |
FL |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Postal Code |
327017829 |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
| Provider Business Practice Location Address Telephone Number |
5173512598 |
The telephone number associated with the location address of the provider being identified. |
| Provider Enumeration Date |
1/25/2008 |
The date the provider was assigned a unique identifier (assigned an NPI). |
| Last Update Date |
1/25/2008 |
The date that a record was last updated or changed. |
| Authorized Official Last Name |
ROMAN |
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider. |
| Authorized Official First Name |
ARLENE |
The first name of the authorized official. |
| Authorized Official Middle Name |
Z |
The middle name of the authorized official. |
| Authorized Official Title or Position |
OWNER |
The code designating the provider’s gender if the provider is a person. |
| Authorized Official Telephone Number |
5176769788 |
The 10-position telephone number of the authorized official. |
| Healthcare Provider Taxonomy Code 1 |
2084P0805X |
The 10-position telephone number of the authorized official. |
| Provider License Number 1 |
ME91100 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
| Provider License Number State Code 1 |
FL |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
| Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
| Is Organization Subpart |
N |
|
| Authorized Official Credential Text |
MD |
|
| Healthcare Provider Taxonomy Group 1 |
193400000X SINGLE SPECIALTY GROUP |
|