{
"Npi": {
"NPI": "1376978783",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ISLAND COAST HOME HEALTH LLC",
"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": "4456 TAMIAMI TRL",
"SecondLineMailingAddress": "A-10 #3",
"MailingAddressCityName": "PUNTA GORDA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33980-2101",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4456 TAMIAMI TRL",
"SecondLinePracticeLocationAddress": "A-10 #3",
"PracticeLocationAddressCityName": "PUNTA GORDA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33980-2101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-766-7201",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/05/2013",
"LastUpdateDate": "09/05/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOBBINS",
"AuthorizedOfficialFirstName": "SHARON",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN, BSN, COS-C",
"AuthorizedOfficialTelephoneNumber": "239-634-4194",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}