{
"Npi": {
"NPI": "1841322005",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FLORIDA HEALTH CARE PLANS 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": "2450 MASON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DAYTONA BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32114-5110",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-615-5008",
"MailingAddressFaxNumber": "386-676-7165",
"FirstLinePracticeLocationAddress": "350 N CLYDE MORRIS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DAYTONA BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32114-2733",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "386-248-0832",
"PracticeLocationAddressFaxNumber": "386-238-3263",
"EnumerationDate": "03/12/2007",
"LastUpdateDate": "04/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "CHRISTOPHER",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "CMO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "386-615-5008",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336M0003X",
"TaxonomyName": "Managed Care Organization Pharmacy",
"LicenseNumber": "PH23787",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}