{
"Npi": {
"NPI": "1790302024",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SMART ENDEAVORS THERAPY SERVICES, LLC.",
"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": "1222 SE 47TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAPE CORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33904-9661",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-888-9696",
"MailingAddressFaxNumber": "239-567-5878",
"FirstLinePracticeLocationAddress": "1222 SE 47TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CAPE CORAL",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33904-9661",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-888-9696",
"PracticeLocationAddressFaxNumber": "239-567-5878",
"EnumerationDate": "07/02/2020",
"LastUpdateDate": "07/02/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "ALEXANDER",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "239-888-9696",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}