{
"Npi": {
"NPI": "1275273245",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AJAMI",
"FirstName": "GAVIN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD, MPH",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "555 NORTHEAST 15TH STREET",
"SecondLineMailingAddress": "SUITE 35C",
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33132",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "549-562-2351",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "555 NORTHEAST 15TH STREET",
"SecondLinePracticeLocationAddress": "UNIT 35C",
"PracticeLocationAddressCityName": "MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33132",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-938-3359",
"PracticeLocationAddressFaxNumber": "954-492-5790",
"EnumerationDate": "03/29/2022",
"LastUpdateDate": "08/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "202D00000X",
"TaxonomyName": "Integrative Medicine Physician",
"LicenseNumber": "35800",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}