{
"Npi": {
"NPI": "1861841827",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AHEB REHABILITATION CLINIC, INC.",
"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": "5975 WEST SUNRISE BLVD., SUITE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUNRISE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33313-6177",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-533-8678",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5975 WEST SUNRISE BLVD.",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "SUNRISE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33313-1046",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-617-4049",
"PracticeLocationAddressFaxNumber": "954-252-4606",
"EnumerationDate": "06/09/2016",
"LastUpdateDate": "03/11/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARTORELL",
"AuthorizedOfficialFirstName": "VIVIAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMHC",
"AuthorizedOfficialTelephoneNumber": "407-617-4049",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}