{
"Npi": {
"NPI": "1679639322",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SFMSC.COM, 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": "6700 GRIFFIN RD",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "DAVIE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33314-4300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-791-9391",
"MailingAddressFaxNumber": "954-791-9338",
"FirstLinePracticeLocationAddress": "6700 GRIFFIN RD",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "DAVIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33314-4300",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-791-9391",
"PracticeLocationAddressFaxNumber": "954-791-9338",
"EnumerationDate": "12/28/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STRAIN",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "954-791-9391",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302F00000X",
"TaxonomyName": "Exclusive Provider Organization",
"LicenseNumber": "54300",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}