{
"Npi": {
"NPI": "1811179021",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREY DOG II INC",
"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": "6200 SUNSET DR",
"SecondLineMailingAddress": "STE 102",
"MailingAddressCityName": "SOUTH MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33143-4828",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-666-1605",
"MailingAddressFaxNumber": "305-666-1688",
"FirstLinePracticeLocationAddress": "6200 SUNSET DR",
"SecondLinePracticeLocationAddress": "STE 102",
"PracticeLocationAddressCityName": "SOUTH MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33143-4828",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-666-1605",
"PracticeLocationAddressFaxNumber": "305-666-1688",
"EnumerationDate": "11/29/2007",
"LastUpdateDate": "11/04/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SEFFAR",
"AuthorizedOfficialFirstName": "ALI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PIC",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RPH",
"AuthorizedOfficialTelephoneNumber": "305-666-1648",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PH23091",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}