{
"Npi": {
"NPI": "1568705606",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COASTAL LIVING LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1800 33RD ST",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "ORLANDO",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32839-8852",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-451-5894",
"MailingAddressFaxNumber": "407-386-6267",
"FirstLinePracticeLocationAddress": "1275 N BANANA RIVER DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MERRITT ISLAND",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32952-5788",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-704-6190",
"PracticeLocationAddressFaxNumber": "407-386-6267",
"EnumerationDate": "03/27/2013",
"LastUpdateDate": "03/27/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FINES",
"AuthorizedOfficialFirstName": "ANDREA",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "407-451-5894",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "AL11441",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}