{
"Npi": {
"NPI": "1144310319",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BENAK INC",
"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": "1600 SW 2ND AVE # VAE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OKEECHOBEE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34974-6122",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "863-462-4479",
"MailingAddressFaxNumber": "863-462-4480",
"FirstLinePracticeLocationAddress": "1600 SW 2ND AVE # VAE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OKEECHOBEE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34974-6122",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "863-462-4479",
"PracticeLocationAddressFaxNumber": "863-462-4480",
"EnumerationDate": "10/16/2006",
"LastUpdateDate": "01/24/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JANNU",
"AuthorizedOfficialFirstName": "SMRUTHI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/ PHARMACY MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-231-7788",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH18931",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}