{
"Npi": {
"NPI": "1487024568",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "L.C. ERBE O.D. P.A.",
"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": "474 SW HOMELAND RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORT SAINT LUCIE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34953-6278",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-873-0037",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1721 SW GATLIN BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT SAINT LUCIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34953-2757",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-873-0037",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/01/2015",
"LastUpdateDate": "10/01/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ERBE",
"AuthorizedOfficialFirstName": "LYNNE",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "772-873-0037",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "152WP0200X",
"TaxonomyName": "Pediatric Optometrist",
"LicenseNumber": "OPC 3336",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152WS0006X",
"TaxonomyName": "Sports Vision Optometrist",
"LicenseNumber": "OPC 3336",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152WV0400X",
"TaxonomyName": "Vision Therapy Optometrist",
"LicenseNumber": "OPC 3336",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPC 3336",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}