{
"Npi": {
"NPI": "1922351436",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HYBRID PHARMA LLC",
"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": "1015 W NEWPORT CENTER DR STE 106A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DEERFIELD BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33442-7707",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-708-2771",
"MailingAddressFaxNumber": "561-542-6791",
"FirstLinePracticeLocationAddress": "1015 W NEWPORT CENTER DR STE 106A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEERFIELD BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33442-7707",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-708-2771",
"PracticeLocationAddressFaxNumber": "561-542-6791",
"EnumerationDate": "10/22/2012",
"LastUpdateDate": "04/21/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAJALINGAM",
"AuthorizedOfficialFirstName": "PONSWAMY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "954-708-2771",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336S0011X",
"TaxonomyName": "Specialty Pharmacy",
"LicenseNumber": "PH26436",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}