{
"Npi": {
"NPI": "1861397960",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "HMA SANTA ROSA MEDICAL CENTER LLC",
"ParentOrgTIN": null,
"OrgName": "HMA SANTA ROSA MEDICAL CENTER LLC",
"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": "6002 BERRYHILL RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MILTON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32570-5062",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-626-7762",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4250 WOODBINE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PACE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32571-8703",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "850-983-4486",
"PracticeLocationAddressFaxNumber": "850-994-4271",
"EnumerationDate": "10/09/2026",
"LastUpdateDate": "10/09/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LALOR",
"AuthorizedOfficialFirstName": "PAULA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SENIOR DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "629-215-3953",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QE0002X",
"TaxonomyName": "Emergency Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}