{
"Npi": {
"NPI": "1972870327",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VIDAL",
"FirstName": "FERMIN",
"MiddleName": "O",
"NamePrefix": "MR.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "VIDAL",
"OtherFirstName": "FERMIN",
"OtherMiddleName": "O",
"OtherNamePrefix": "MR.",
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "423 NW 101ST ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GAINESVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32607-1388",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-322-1637",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "807 E SILVER SPRINGS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34470-6709",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-629-8721",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/29/2011",
"LastUpdateDate": "11/29/2011",
"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": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "0023561",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}