{
"Npi": {
"NPI": "1831534577",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAKES REHAB",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5803 NW 151ST ST STE 107",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI LAKES",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33014-2473",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-929-8450",
"MailingAddressFaxNumber": "305-827-4422",
"FirstLinePracticeLocationAddress": "5803 NW 151ST ST STE 107",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIAMI LAKES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33014-2473",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-929-8450",
"PracticeLocationAddressFaxNumber": "305-827-4422",
"EnumerationDate": "05/08/2013",
"LastUpdateDate": "05/08/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CUNILL",
"AuthorizedOfficialFirstName": "RICHET",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "305-929-8441",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "HCC6514",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}