{
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"OrgName": "ARIZONA HEART 360, P.C.",
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"FirstLineMailingAddress": "13208 N 13TH PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85022-4932",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-434-1956",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "20045 N 19TH AVE STE 165",
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"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85027-4254",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-404-3115",
"PracticeLocationAddressFaxNumber": "623-215-7670",
"EnumerationDate": "08/14/2017",
"LastUpdateDate": "05/10/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DESAI",
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"AuthorizedOfficialTitle": "CARDIOLOGIST",
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"AuthorizedOfficialCredential": "DO",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "0005794",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}