{
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"ParentOrgLBN": null,
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"OrgName": "TOTAL EYE CARE PA",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 747",
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"MailingAddressCityName": "HOLLYWOOD",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20636-0747",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "763-746-2094",
"MailingAddressFaxNumber": "240-317-5185",
"FirstLinePracticeLocationAddress": "4175 VINEWOOD LN N",
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"PracticeLocationAddressCityName": "PLYMOUTH",
"PracticeLocationAddressStateName": "MN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "763-553-2883",
"PracticeLocationAddressFaxNumber": "240-317-5185",
"EnumerationDate": "09/22/2006",
"LastUpdateDate": "05/14/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ANDERSON",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": "BRUCE",
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"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "952-381-7611",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261Q00000X",
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
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"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."
}
}
}
}