{
"Npi": {
"NPI": "1265756563",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DAVIE URGENT CARE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "350 N PINE ISLAND RD",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "PLANTATION",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33324-1849",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-476-8800",
"MailingAddressFaxNumber": "954-476-1362",
"FirstLinePracticeLocationAddress": "4765 SW 148TH AVE",
"SecondLinePracticeLocationAddress": "SUITE 401",
"PracticeLocationAddressCityName": "DAVIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33330-2128",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-476-8800",
"PracticeLocationAddressFaxNumber": "954-476-1362",
"EnumerationDate": "03/16/2010",
"LastUpdateDate": "05/25/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "954-476-8800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "L10000015662",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}