{
"Npi": {
"NPI": "1134155294",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VANDORMAEL",
"FirstName": "MICHEL",
"MiddleName": "GUY",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2000 NW 87TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33172-2654",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "844-665-4827",
"MailingAddressFaxNumber": "866-523-6595",
"FirstLinePracticeLocationAddress": "15600 NW 67TH AVE STE 301",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIAMI LAKES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33014-2176",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "844-665-4827",
"PracticeLocationAddressFaxNumber": "877-807-0603",
"EnumerationDate": "06/23/2006",
"LastUpdateDate": "03/15/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "ME87973",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "ME 87973",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RI0011X",
"TaxonomyName": "Interventional Cardiology Physician",
"LicenseNumber": "ME 87973",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}