{"npi":"1811488554","type":"NPI-2","status":"active","name":{"display":"Ketamine Health Centers, LLC","other":[],"organization_name":"KETAMINE HEALTH CENTERS, LLC","authorised_official":"Raul Cruz"},"specialty":{"primary_taxonomy":"261QH0100X","primary_taxonomy_description":"Health Service Clinic/Center","slug":"health-service-clinic-center","schema_org_specialty":null,"all":[{"code":"261QH0100X","description":"Health Service Clinic/Center","primary":true,"state":"FL","license":"607228"}]},"addresses":[{"purpose":"LOCATION","street_1":"9408 SW 87TH AVE STE 302","city":"MIAMI","state":"FL","postal_code":"331762416","country_code":"US","phone":"3058569442"},{"purpose":"MAILING","street_1":"9408 SW 87TH AVE STE 302","city":"MIAMI","state":"FL","postal_code":"331762416","country_code":"US","phone":"3058569442"}],"license":{"state":"FL","number":"607228"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"1104163294","state":"FL","issuer":null},{"type_code":"05","label":"Medicaid","value":"1144421454","state":"FL","issuer":null},{"type_code":"05","label":"Medicaid","value":"187533935","state":"FL","issuer":null},{"type_code":"05","label":"Medicaid","value":"1194817221","state":"FL","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2018-05-29","last_updated":"2023-07-31","_meta":{"source":"NPPES","snapshot_date":"2023-07-31","doc_url":"https://findmynpi.com/api"}}