{
"Npi": {
"NPI": "1184863151",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "COMPREHENSIVE HEALTH CENTER LLC",
"ParentOrgTIN": null,
"OrgName": "COMPREHENSIVE URGENT CARE INC.",
"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": "671 NW 119TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33168-2522",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-688-0811",
"MailingAddressFaxNumber": "305-687-5831",
"FirstLinePracticeLocationAddress": "671 NW 119TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33168-2522",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-688-0188",
"PracticeLocationAddressFaxNumber": "305-687-5831",
"EnumerationDate": "02/13/2009",
"LastUpdateDate": "02/13/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOISE",
"AuthorizedOfficialFirstName": "RUDOLPH",
"AuthorizedOfficialMiddleName": "GUY",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "305-688-0811",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "0S4440",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}