{
"Npi": {
"NPI": "1992096788",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JM2GO, 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": "PO BOX 61105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT MYERS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33906-1105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-565-8300",
"MailingAddressFaxNumber": "239-829-4709",
"FirstLinePracticeLocationAddress": "9400 GLADIOLUS DR",
"SecondLinePracticeLocationAddress": "SUITE #60",
"PracticeLocationAddressCityName": "FORT MYERS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33908-6699",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-565-8300",
"PracticeLocationAddressFaxNumber": "239-565-8300",
"EnumerationDate": "04/27/2011",
"LastUpdateDate": "04/27/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "SANTO",
"AuthorizedOfficialMiddleName": "IGNACIO",
"AuthorizedOfficialTitle": "MANAGING DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR/L",
"AuthorizedOfficialTelephoneNumber": "239-565-8300",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225X00000X",
"TaxonomyName": "Occupational Therapist",
"LicenseNumber": "OT11998",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}