NPIMap

Organization Active NPI

Justitia Haddad

  • Specialist
  • Bradenton, FL
National Provider Identifier
1477801108
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
OTA 10758 Issued in FL
Legal business name
JUSTITIA HADDAD
Practice address
4312 55TH Ave Drive East
Bradenton, FL 34203
Phone
(941) 962-3312
NPI assigned
Aug 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Justitia Haddad
Title
Cota
Phone
(941) 962-3312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X OTA 10758 FL Primary

Addresses

Primary practice location

4312 55TH Ave Drive East
Bradenton, FL 34203

Mailing address

4312 55TH Ave Drive East
Bradenton, FL 34203
Phone (941) 962-3312

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1477801108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 55TH AVE DRIVE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34203",
            "telephone_number": "941-962-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4312 55TH AVE DRIVE EAST",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "34203",
            "telephone_number": "941-962-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTITIA HADDAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "JUSTITIA",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "941-962-3312"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "OTA 10758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.