{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "UNITED HEALTH MEDICAL GROUP INC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "2423 SW 147TH AVE STE 145",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33185-4082",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-910-7237",
"MailingAddressFaxNumber": "305-223-9577",
"FirstLinePracticeLocationAddress": "3890 W COMMERCIAL BLVD STE 217",
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"PracticeLocationAddressCityName": "TAMARAC",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33309-3319",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-530-2820",
"PracticeLocationAddressFaxNumber": "954-530-2840",
"EnumerationDate": "11/05/2009",
"LastUpdateDate": "11/05/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAMIREZ",
"AuthorizedOfficialFirstName": "EDUARDO",
"AuthorizedOfficialMiddleName": "RAUL",
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "305-910-7237",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH7714",
"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."
}
}
}
}