{
"Npi": {
"NPI": "1134359383",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FAMILY EYEWEAR",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8177 GLADES RD",
"SecondLineMailingAddress": "BAY#3",
"MailingAddressCityName": "BOCA RATON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33434-4071",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-479-4765",
"MailingAddressFaxNumber": "561-479-4628",
"FirstLinePracticeLocationAddress": "8177 GLADES RD",
"SecondLinePracticeLocationAddress": "BAY#3",
"PracticeLocationAddressCityName": "BOCA RATON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33434-4071",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-479-4765",
"PracticeLocationAddressFaxNumber": "561-479-4628",
"EnumerationDate": "07/22/2009",
"LastUpdateDate": "07/22/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAMPOREALE",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "MARC",
"AuthorizedOfficialTitle": "OWNER/LISCENSED OPTICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.D.O",
"AuthorizedOfficialTelephoneNumber": "561-479-4765",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "156FX1800X",
"TaxonomyName": "Optician",
"LicenseNumber": "5930",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}