{
"Npi": {
"NPI": "1700336914",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FURSANKIM GROUP LLC",
"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": "22 REDWOOD TRACK TER",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCALA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34472-6074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-343-0262",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13940 N US HIGHWAY 441",
"SecondLinePracticeLocationAddress": "OAKLAND HILL PROFESSIONAL CENTER, STE 905",
"PracticeLocationAddressCityName": "LADY LAKE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32159-8908",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "651-343-0262",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/12/2016",
"LastUpdateDate": "10/12/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANGI",
"AuthorizedOfficialFirstName": "SARANTUYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LAC",
"AuthorizedOfficialTelephoneNumber": "651-343-0262",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "AP3710",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}