{
"Npi": {
"NPI": "1922085208",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SAPPHIRE BRANDON LTD",
"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": "615 VONDERBURG DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRANDON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33511-5972",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-205-0312",
"MailingAddressFaxNumber": "813-657-6130",
"FirstLinePracticeLocationAddress": "615 VONDERBURG DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRANDON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33511-5972",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-657-5579",
"PracticeLocationAddressFaxNumber": "813-675-6130",
"EnumerationDate": "12/28/2005",
"LastUpdateDate": "09/16/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STONE",
"AuthorizedOfficialFirstName": "JEFFREY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT AND CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-205-0312",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "HCC4890",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}