{
"Npi": {
"NPI": "1023446911",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALLAN R SIDORSKY DCPA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "339 BEACON POINTE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCOEE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34761-4414",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-673-2820",
"MailingAddressFaxNumber": "407-253-1470",
"FirstLinePracticeLocationAddress": "1151 BLACKWOOD AVE",
"SecondLinePracticeLocationAddress": "SUITE 110",
"PracticeLocationAddressCityName": "OCOEE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34761-4550",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-205-8847",
"PracticeLocationAddressFaxNumber": "407-253-1470",
"EnumerationDate": "10/31/2013",
"LastUpdateDate": "10/31/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIDORSKY",
"AuthorizedOfficialFirstName": "ALLAN",
"AuthorizedOfficialMiddleName": "ROBERT",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "954-673-2820",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": null,
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X 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."
}
}
}
}