{
"Npi": {
"NPI": "1932376233",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SYMPHONY DIAGNOSTIC SERVICES NO 1 LLC",
"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": "930 RIDGEBROOK RD FL 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPARKS",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21152-9481",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-786-8015",
"MailingAddressFaxNumber": "443-662-4230",
"FirstLinePracticeLocationAddress": "4400 140TH AVE N STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLEARWATER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33762-3813",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-786-8015",
"PracticeLocationAddressFaxNumber": "443-842-7264",
"EnumerationDate": "05/15/2008",
"LastUpdateDate": "08/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CUOMO",
"AuthorizedOfficialFirstName": "BRIAN",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "AUTHORIZED OFFICIAL/CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "800-786-8015",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "293D00000X",
"TaxonomyName": "Physiological Laboratory",
"LicenseNumber": "3008665",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}