{
"Npi": {
"NPI": "1063671246",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EMAD EKLADIOS M D P A",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 848488",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEMBROKE PINES",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33084-0488",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-963-2555",
"MailingAddressFaxNumber": "954-963-2288",
"FirstLinePracticeLocationAddress": "2231 N UNIVERSITY DR",
"SecondLinePracticeLocationAddress": "SUITE C",
"PracticeLocationAddressCityName": "PEMBROKE PINES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33024-3611",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-963-2555",
"PracticeLocationAddressFaxNumber": "954-963-2288",
"EnumerationDate": "06/03/2008",
"LastUpdateDate": "08/26/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EKLADIOS",
"AuthorizedOfficialFirstName": "EMAD",
"AuthorizedOfficialMiddleName": "EZRA",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M D",
"AuthorizedOfficialTelephoneNumber": "954-963-2555",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "ME0064340",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}