{
"Npi": {
"NPI": "1255798427",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WARREN S. KLUGER, MD, PA",
"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": "1320 PRINCE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST AUGUSTINE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32086-6536",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-662-7544",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3100 US 1 S",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ST AUGUSTINE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32086-6351",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-797-3686",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/19/2016",
"LastUpdateDate": "01/19/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KLUGER",
"AuthorizedOfficialFirstName": "WARREN",
"AuthorizedOfficialMiddleName": "S.",
"AuthorizedOfficialTitle": "SURGEON",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD, PA",
"AuthorizedOfficialTelephoneNumber": "904-797-3686",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "246QM0706X",
"TaxonomyName": "Medical Technologist",
"LicenseNumber": "TN-33842",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "246ZC0007X",
"TaxonomyName": "Surgical Assistant",
"LicenseNumber": "TN-33842",
"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."
},
{
"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."
}
]
}
}
}