{
"Npi": {
"NPI": "1376849083",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PARKDALE PHARMACUTICALS CORP",
"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": "247 SW 8TH ST",
"SecondLineMailingAddress": "#248",
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33130-3529",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "202-437-6608",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6714 PINES BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PEMBROKE PINES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33024-7544",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-332-6669",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/28/2011",
"LastUpdateDate": "01/28/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FACEY",
"AuthorizedOfficialFirstName": "ROBERTO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "202-437-6608",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "PH25213",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}