{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MCCLANE & STUBITS OD PA",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6 S 14TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FERNANDINA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32034-3212",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-261-5741",
"MailingAddressFaxNumber": "904-261-7383",
"FirstLinePracticeLocationAddress": "6 S 14TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FERNANDINA BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32034-3212",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-261-5741",
"PracticeLocationAddressFaxNumber": "904-261-7383",
"EnumerationDate": "08/14/2006",
"LastUpdateDate": "02/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCLANE",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": "W",
"AuthorizedOfficialTitle": "PRESIDENT OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": "OD",
"AuthorizedOfficialTelephoneNumber": "904-261-5741",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "1488",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE 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."
}
}
}
}