{
"Npi": {
"NPI": "1568766020",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EYE EXPRESS, INC.",
"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": "215 1ST ST N",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "WINTER HAVEN",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33881-4537",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "863-299-8908",
"MailingAddressFaxNumber": "863-595-2838",
"FirstLinePracticeLocationAddress": "500 E CENTRAL AVE",
"SecondLinePracticeLocationAddress": "OPTICAL SUITE",
"PracticeLocationAddressCityName": "WINTER HAVEN",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33880-3053",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "863-299-8908",
"PracticeLocationAddressFaxNumber": "863-595-2838",
"EnumerationDate": "12/27/2010",
"LastUpdateDate": "12/27/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "STEPHEN",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "863-299-8908",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "OPC931",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}