{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "MARK P CARUSO, OD, PA",
"LastName": null,
"FirstName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "633 NW 28TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WILTON MANORS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33311-2462",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-630-3070",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7730 W COMMERCIAL BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SUNRISE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33351-4301",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-578-1746",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/22/2007",
"LastUpdateDate": "10/07/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARUSO",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "954-630-3070",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPC3097",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}