{
"Npi": {
"NPI": "1912310780",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CAPE CORAL EYE CENTER, P.A.",
"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": "PO BOX 101427",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAPE CORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33910-1427",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-542-2020",
"MailingAddressFaxNumber": "239-541-1492",
"FirstLinePracticeLocationAddress": "2335 TAMIAMI TRL N STE 304",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NAPLES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34103-4457",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-542-2020",
"PracticeLocationAddressFaxNumber": "239-542-0704",
"EnumerationDate": "06/09/2014",
"LastUpdateDate": "06/09/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TYSON",
"AuthorizedOfficialFirstName": "FARRELL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR/ OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "239-542-2020",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QS0132X",
"TaxonomyName": "Ophthalmologic Surgery Clinic/Center",
"LicenseNumber": "ME81910",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}