{
"Npi": {
"NPI": "1497255814",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PLANTATION MEDICAL CARE, 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": "9030 W FORT ISLAND TRL STE 11B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CRYSTAL RIVER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34429-2415",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-651-5127",
"MailingAddressFaxNumber": "352-651-5129",
"FirstLinePracticeLocationAddress": "9030 W FORT ISLAND TRL STE 11B",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CRYSTAL RIVER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34429",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-651-5127",
"PracticeLocationAddressFaxNumber": "352-651-5129",
"EnumerationDate": "02/13/2018",
"LastUpdateDate": "06/21/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HESS",
"AuthorizedOfficialFirstName": "ADRIANNE",
"AuthorizedOfficialMiddleName": "ASHMORE",
"AuthorizedOfficialTitle": "OFFICE MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "352-651-5127",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "OS4310",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207QA0505X",
"TaxonomyName": "Adult Medicine Physician",
"LicenseNumber": "OS-0004310",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}