{
"Npi": {
"NPI": "1508146101",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MIRAMAR PRIMARY CARE CENTER 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": "18300 NW 62ND AVE",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "HIALEAH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33015-8200",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-628-4600",
"MailingAddressFaxNumber": "305-628-8090",
"FirstLinePracticeLocationAddress": "3220 S DOUGLAS RD",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "MIRAMAR",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33025-2734",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-433-9923",
"PracticeLocationAddressFaxNumber": "954-450-0537",
"EnumerationDate": "08/26/2011",
"LastUpdateDate": "10/13/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANCHEZ",
"AuthorizedOfficialFirstName": "FERNANDO",
"AuthorizedOfficialMiddleName": "DE JESUS",
"AuthorizedOfficialTitle": "MBR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "305-628-4600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "ME51638",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}