{
"Npi": {
"NPI": "1376814707",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ROY J CACCIAGUIDA MD PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7780 IRONHORSE BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WEST PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33412-2423",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-832-3004",
"MailingAddressFaxNumber": "561-833-0460",
"FirstLinePracticeLocationAddress": "1500 N DIXIE HWY STE 201",
"SecondLinePracticeLocationAddress": "201",
"PracticeLocationAddressCityName": "WEST PALM BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33401-2716",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-832-3004",
"PracticeLocationAddressFaxNumber": "561-833-0460",
"EnumerationDate": "01/17/2012",
"LastUpdateDate": "10/23/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CACCIAGUIDA MD PA",
"AuthorizedOfficialFirstName": "ROY",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "DOCTOR/OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD PA",
"AuthorizedOfficialTelephoneNumber": "561-832-3004",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "ME019768",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}