{
"Npi": {
"NPI": "1619827359",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TRIPLE M MEDICAL SERVICES 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": "40111 BABB RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "UMATILLA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32784-9002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-308-1766",
"MailingAddressFaxNumber": "352-329-4343",
"FirstLinePracticeLocationAddress": "10 W LAKEVIEW AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EUSTIS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32726-5407",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-308-1766",
"PracticeLocationAddressFaxNumber": "352-329-4343",
"EnumerationDate": "02/02/2026",
"LastUpdateDate": "02/02/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SLAGTER",
"AuthorizedOfficialFirstName": "TAYLOR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PROVIDER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "APRN",
"AuthorizedOfficialTelephoneNumber": "407-402-4812",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}