{
"Npi": {
"NPI": "1972740637",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "A.C.A. LABORATORIES, LLC",
"ParentOrgTIN": null,
"OrgName": "A.C.A. CLINICAL LABORATORIES, 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": "2930 E FONTANA CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROYAL PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33411-6804",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "989-708-1335",
"MailingAddressFaxNumber": "561-383-5625",
"FirstLinePracticeLocationAddress": "999 SW 71ST AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH LAUDERDALE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33068-2313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "989-708-1335",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/16/2009",
"LastUpdateDate": "01/16/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ACHILLE",
"AuthorizedOfficialFirstName": "FELIX",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "989-708-1335",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}