{
  "npi": "1053716936",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "PARVINDER",
    "authorized_official_last_name": "KAINTH",
    "authorized_official_middle_name": "S",
    "authorized_official_telephone_number": "4077536310",
    "authorized_official_title_or_position": "Manager",
    "certification_date": "2020-05-29",
    "enumeration_date": "2014-11-04",
    "last_updated": "2020-05-29",
    "organization_name": "ADVANCED RX DERM, LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "7500 GULF BLVD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "ST PETE BEACH",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "844-566-0501",
      "postal_code": "337061821",
      "state": "FL",
      "telephone_number": "407-753-6310"
    },
    {
      "address_1": "PO BOX 1730",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "LUTZ",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "335481730",
      "state": "FL"
    }
  ],
  "taxonomies": [
    {
      "code": "3336L0003X",
      "desc": "Pharmacy, Long Term Care Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336S0011X",
      "desc": "Pharmacy, Specialty Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": "PH28614",
      "primary": true,
      "state": "FL",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}