{
"Npi": {
"NPI": "1972585651",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SURGERY SPECIALISTS OF BROWARD INC",
"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": "PO BOX 451986",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUNRISE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33345-1986",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-838-2371",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7421 N UNIVERSITY DR",
"SecondLinePracticeLocationAddress": "SUITE 205",
"PracticeLocationAddressCityName": "TAMARAC",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33321-2977",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-476-9899",
"PracticeLocationAddressFaxNumber": "954-476-9180",
"EnumerationDate": "11/17/2005",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GOLD",
"AuthorizedOfficialFirstName": "LEWIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "954-838-2371",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208C00000X",
"TaxonomyName": "Colon & Rectal Surgery Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"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."
}
}
}
}