{
"Npi": {
"NPI": "1518315860",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CRITICALNEEDMEDICINE HEALTHYFAMILY HEALTHYCOMMUNITY",
"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": "4910 14TH ST W",
"SecondLineMailingAddress": "SUITE 208",
"MailingAddressCityName": "BRADENTON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34207-2482",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-755-7700",
"MailingAddressFaxNumber": "941-755-8100",
"FirstLinePracticeLocationAddress": "4910 14TH ST W",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "BRADENTON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34207-2482",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-755-7700",
"PracticeLocationAddressFaxNumber": "941-755-8100",
"EnumerationDate": "05/26/2016",
"LastUpdateDate": "05/26/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GASPARD",
"AuthorizedOfficialFirstName": "RICARDO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "941-755-7700",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "ACN472",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}