{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MITCHELL J MARDER P.A.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "11368 ISLAND LAKES LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOCA RATON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33498-6805",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-445-3086",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4923 COCONUT CREEK PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COCONUT CREEK",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33063-3909",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-970-4266",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/11/2012",
"LastUpdateDate": "06/11/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARDER",
"AuthorizedOfficialFirstName": "MITCHELL",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "561-445-3086",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPC001674",
"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."
}
}
}
}