{
"Npi": {
"NPI": "1144402421",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOODLIFE PHARMACY 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": "8903 GLADES RD",
"SecondLineMailingAddress": "STE G13",
"MailingAddressCityName": "BOCA RATON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33434-4074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-999-8855",
"MailingAddressFaxNumber": "561-999-8855",
"FirstLinePracticeLocationAddress": "104 NE 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOCA RATON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33432-3908",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-999-8855",
"PracticeLocationAddressFaxNumber": "561-948-0860",
"EnumerationDate": "11/29/2007",
"LastUpdateDate": "05/14/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GIL",
"AuthorizedOfficialFirstName": "EDUARDO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "561-999-8855",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH23079",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}