{
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"OrgName": "DESAI MEDICAL CENTER FOR PRIMARY CARE AND INTEGRATIVE MEDICINE PA",
"LastName": null,
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"NamePrefix": null,
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"Credential": null,
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"FirstLineMailingAddress": "773 CR 466",
"SecondLineMailingAddress": "THE SUMMIT OF LADY LAKE",
"MailingAddressCityName": "LADY LAKE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32159-6340",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "321-274-1864",
"MailingAddressFaxNumber": "352-259-1132",
"FirstLinePracticeLocationAddress": "773 COUNTY ROAD 466",
"SecondLinePracticeLocationAddress": "THE SUMMIT OF LADY LAKE",
"PracticeLocationAddressCityName": "LADY LAKE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-274-1864",
"PracticeLocationAddressFaxNumber": "352-259-1132",
"EnumerationDate": "01/16/2009",
"LastUpdateDate": "11/06/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DESAI",
"AuthorizedOfficialFirstName": "KALPANA",
"AuthorizedOfficialMiddleName": "P",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "321-274-1864",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "ME92848",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}