{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REPRO SURGICAL, LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8415 N PIMA RD",
"SecondLineMailingAddress": "SUITE 291",
"MailingAddressCityName": "SCOTTSDALE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85258-4480",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-641-6024",
"MailingAddressFaxNumber": "480-434-6572",
"FirstLinePracticeLocationAddress": "8415 N PIMA RD",
"SecondLinePracticeLocationAddress": "SUITE 291",
"PracticeLocationAddressCityName": "SCOTTSDALE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85258-4480",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-641-6024",
"PracticeLocationAddressFaxNumber": "480-434-6572",
"EnumerationDate": "08/02/2016",
"LastUpdateDate": "12/04/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEHERA",
"AuthorizedOfficialFirstName": "MILLIE",
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"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "919-641-6024",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA1903X",
"TaxonomyName": "Ambulatory Surgical Clinic/Center",
"LicenseNumber": "42873",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}