{
"Npi": {
"NPI": "1033077557",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LONGEVITY DAY CLUB AT MERRITT ISLAND LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "941 W MORSE BLVD STE 100",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINTER PARK",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32789-3781",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-428-2480",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3702 N COURTENAY PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRITT ISLAND",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32953-8194",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-986-8500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/13/2026",
"LastUpdateDate": "01/13/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARVAJAL",
"AuthorizedOfficialFirstName": "PILAR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "305-428-2480",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}