{
"Npi": {
"NPI": "1750823233",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PROHEALTH",
"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": "3298 SUMMIT BLVD.",
"SecondLineMailingAddress": "SUITE 33",
"MailingAddressCityName": "PENSACOLA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "32503",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-434-6168",
"MailingAddressFaxNumber": "850-434-3145",
"FirstLinePracticeLocationAddress": "1100 AIRPORT",
"SecondLinePracticeLocationAddress": "BLVD. B",
"PracticeLocationAddressCityName": "PENSACOLA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-549-3379",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/15/2016",
"LastUpdateDate": "11/15/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DUFOUR",
"AuthorizedOfficialFirstName": "DEBBIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OPERATIONS OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "850-434-6168",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "ARNP9365811",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}