{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "JAMILY F PEDRO , DMD, PA",
"LastName": null,
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"MiddleName": null,
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"FirstLineMailingAddress": "7050 W PALMETTO PARK ROAD",
"SecondLineMailingAddress": "SUITE 52",
"MailingAddressCityName": "BOCA RATON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33433",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-394-2592",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7050 W PALMETTO PARK ROAD",
"SecondLinePracticeLocationAddress": "SUITE 52",
"PracticeLocationAddressCityName": "BOCA RATON",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressTelephoneNumber": "561-394-2592",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/14/2013",
"LastUpdateDate": "05/14/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEDRO",
"AuthorizedOfficialFirstName": "JAMILY",
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"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "D.M.D",
"AuthorizedOfficialTelephoneNumber": "561-394-2592",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
"LicenseNumber": "DN19518",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}