{
"Npi": {
"NPI": "1154519791",
"EntityType": "Organization",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VICENTE C FLORIDA MD PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 339",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TITUSVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32781-0339",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "321-267-4700",
"MailingAddressFaxNumber": "321-747-0347",
"FirstLinePracticeLocationAddress": "1309 GARDEN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TITUSVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32796-2548",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-267-4700",
"PracticeLocationAddressFaxNumber": "321-747-0347",
"EnumerationDate": "10/09/2007",
"LastUpdateDate": "11/02/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FLORIDA",
"AuthorizedOfficialFirstName": "VICENTE",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "PRESIDENT/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "321-267-4700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "ME0071351",
"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."
}
}
}
}