{
"Npi": {
"NPI": "1275921777",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OPTIMAL PATIENT 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": "4319 E 7TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TAMPA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33605-4628",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-961-8262",
"MailingAddressFaxNumber": "813-961-8264",
"FirstLinePracticeLocationAddress": "8225 STATE ROAD 54",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW PORT RICHEY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34655-3016",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-372-5206",
"PracticeLocationAddressFaxNumber": "727-372-8474",
"EnumerationDate": "01/06/2015",
"LastUpdateDate": "01/06/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROTEA",
"AuthorizedOfficialFirstName": "FERMIN",
"AuthorizedOfficialMiddleName": "BACALSO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "813-310-1526",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}