{
"Npi": {
"NPI": "1134803471",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARDIOCARE HEART AND VASCULAR CENTER PLLC",
"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": "210 JUPITER LAKES BLVD",
"SecondLineMailingAddress": "BLDG 5000 STE 202",
"MailingAddressCityName": "JUPITER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33458-5810",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-831-8451",
"MailingAddressFaxNumber": "833-968-3335",
"FirstLinePracticeLocationAddress": "210 JUPITER LAKES BLVD",
"SecondLinePracticeLocationAddress": "BLDG 5000 STE 202",
"PracticeLocationAddressCityName": "JUPITER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33458-5810",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-831-8451",
"PracticeLocationAddressFaxNumber": "833-968-3335",
"EnumerationDate": "06/14/2023",
"LastUpdateDate": "10/18/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "EMILIO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "786-427-7558",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}