{
"Npi": {
"NPI": "1104192335",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RX PRO PHARMACY & COMPOUNDING, INC",
"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": "932 W HALLANDALE BEACH BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HALLANDALE BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33009-5241",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-455-0004",
"MailingAddressFaxNumber": "601-982-7103",
"FirstLinePracticeLocationAddress": "932 W HALLANDALE BEACH BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HALLANDALE BEACH",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-455-0004",
"PracticeLocationAddressFaxNumber": "601-982-7103",
"EnumerationDate": "04/02/2012",
"LastUpdateDate": "04/02/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RUTLAND",
"AuthorizedOfficialFirstName": "JASON",
"AuthorizedOfficialMiddleName": "DAVID",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "954-455-0004",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH26011",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}