{
"Npi": {
"NPI": "1760654362",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRANT EYEGLASSES 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": "5248 BANK ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT MYERS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33907-2111",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-334-7268",
"MailingAddressFaxNumber": "239-334-0844",
"FirstLinePracticeLocationAddress": "5248 BANK ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT MYERS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33907-2111",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-334-7268",
"PracticeLocationAddressFaxNumber": "239-334-0844",
"EnumerationDate": "03/24/2008",
"LastUpdateDate": "03/18/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRANT",
"AuthorizedOfficialFirstName": "CHARLES",
"AuthorizedOfficialMiddleName": "E.",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "239-334-7268",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "DO2474",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}