{
"Npi": {
"NPI": "1225000201",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "AMERIPATH INC.",
"ParentOrgTIN": null,
"OrgName": "AMERIPATH INSTITUTE OF UROLOGICAL PATHOLOGY PC",
"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": "7111 FAIRWAY DR",
"SecondLineMailingAddress": "SUITE 400",
"MailingAddressCityName": "PALM BEACH GARDENS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33418-4207",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-712-6265",
"MailingAddressFaxNumber": "561-712-7349",
"FirstLinePracticeLocationAddress": "27472 SCHOENHERR RD",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "WARREN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48088-6688",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-774-5819",
"PracticeLocationAddressFaxNumber": "586-774-5869",
"EnumerationDate": "02/03/2006",
"LastUpdateDate": "03/19/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "01/04/2011",
"NPIReactivationDate": "03/19/2012",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREENE",
"AuthorizedOfficialFirstName": "MICHEL",
"AuthorizedOfficialMiddleName": "H",
"AuthorizedOfficialTitle": "VP",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-932-8270",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "23D1024436",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}