{
"Npi": {
"NPI": "1922585975",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ORIVE",
"FirstName": "CARLOS",
"MiddleName": "E",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "ARNP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "ORIVE",
"OtherFirstName": "CARLOS",
"OtherMiddleName": "E",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "APRN",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "606 ALMANSA ST NE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALM BAY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32907-3121",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-494-8626",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4450 W EAU GALLIE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MELBOURNE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32934-7213",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-372-8567",
"PracticeLocationAddressFaxNumber": "321-752-2595",
"EnumerationDate": "07/23/2018",
"LastUpdateDate": "03/30/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "APRN9367177",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "APRN9367177",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}