{
"Npi": {
"NPI": "1225378516",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JOHN BANCROFT HYLTON M.D,P.A",
"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": "12323 SW 55TH ST",
"SecondLineMailingAddress": "SUITE 1003",
"MailingAddressCityName": "COOPER CITY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33330-3312",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-252-0083",
"MailingAddressFaxNumber": "954-252-0207",
"FirstLinePracticeLocationAddress": "12323 SW 55TH ST",
"SecondLinePracticeLocationAddress": "SUITE 1003",
"PracticeLocationAddressCityName": "COOPER CITY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33330-3312",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-252-0083",
"PracticeLocationAddressFaxNumber": "954-252-0207",
"EnumerationDate": "02/22/2013",
"LastUpdateDate": "05/21/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HYLTON",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "BANCROFT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "954-252-0083",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "ME0060538",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}