{
"Npi": {
"NPI": "1700306099",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NINETTE&DAIMIS CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3157 N UNIVERSITY DR STE 103",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOLLYWOOD",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33024-2258",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-332-8985",
"MailingAddressFaxNumber": "954-332-8981",
"FirstLinePracticeLocationAddress": "3157 N UNIVERSITY DR STE 103",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOLLYWOOD",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33024-2258",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-332-8985",
"PracticeLocationAddressFaxNumber": "954-332-8981",
"EnumerationDate": "06/27/2017",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAZQUEZ ROSABAL",
"AuthorizedOfficialFirstName": "DAIMIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "786-343-3552",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "ACN676",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}