{
"Npi": {
"NPI": "1578838637",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAN LAZARO REHAB CENTER CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2500 NW 79TH AVE STE 288",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33122-1090",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2500 NW 79TH AVE STE 288",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DORAL",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33122-1090",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-290-3750",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/21/2012",
"LastUpdateDate": "03/21/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARCE",
"AuthorizedOfficialFirstName": "ANIER",
"AuthorizedOfficialMiddleName": "EMILIO",
"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MA",
"AuthorizedOfficialTelephoneNumber": "786-327-8517",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": "MA58457",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}