{
"Npi": {
"NPI": "1992002612",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PICENTI 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": "11147 COUNTY LINE RD",
"SecondLineMailingAddress": "101",
"MailingAddressCityName": "SPRING HILL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34609",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-244-3670",
"MailingAddressFaxNumber": "352-340-5973",
"FirstLinePracticeLocationAddress": "11147 COUNTY LINE RD",
"SecondLinePracticeLocationAddress": "101",
"PracticeLocationAddressCityName": "SPRING HILL",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34609-5619",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-244-3670",
"PracticeLocationAddressFaxNumber": "352-340-5973",
"EnumerationDate": "02/15/2011",
"LastUpdateDate": "02/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TOLBA",
"AuthorizedOfficialFirstName": "ALAN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "727-244-3670",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "PS 42024",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}