{
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"IsOrgSubpart": "N",
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"OrgName": "SOFIA TSELIKIS MD LTD",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"FirstLineMailingAddress": "2251 N RAMPART BLVD",
"SecondLineMailingAddress": "#376",
"MailingAddressCityName": "LAS VEGAS",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89128-7640",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-860-3467",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3100 N TENAYA WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NV",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "702-453-3799",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/21/2007",
"LastUpdateDate": "01/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TSELIKIS",
"AuthorizedOfficialFirstName": "SOFIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "702-453-3799",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208M00000X",
"TaxonomyName": "Hospitalist Physician",
"LicenseNumber": "11034",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}