{
"Npi": {
"NPI": "1164958773",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "PEEPERS EYECARE INC",
"ParentOrgTIN": null,
"OrgName": "PEEPERS EYECARE 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": "2478 BURNSED BLVD #466A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "THE VILLAGES",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32163",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-399-5412",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2478 BURNSED BLVD #466A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "THE VILLAGES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32163",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-399-5412",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/03/2017",
"LastUpdateDate": "05/03/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SALMAN",
"AuthorizedOfficialFirstName": "IBRAHIM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "352-259-1621",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "156FX1800X",
"TaxonomyName": "Optician",
"LicenseNumber": "DO5201",
"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."
}
}
}
}