{
"Npi": {
"NPI": "1588958342",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMPLETE URGENT HEALTHCARE 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": "20665 LYONS RD",
"SecondLineMailingAddress": "#A3",
"MailingAddressCityName": "BOCA RATON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33434-3947",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-309-7815",
"MailingAddressFaxNumber": "561-640-9282",
"FirstLinePracticeLocationAddress": "2517 SEMINOLE CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WEST PALM BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33409-7460",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "516-309-7815",
"PracticeLocationAddressFaxNumber": "516-640-9282",
"EnumerationDate": "06/08/2011",
"LastUpdateDate": "06/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOLDSTEIN",
"AuthorizedOfficialFirstName": "EVAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "561-309-7815",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QU0200X",
"TaxonomyName": "Urgent Care Clinic/Center",
"LicenseNumber": "ME0064033",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}