{
"Npi": {
"NPI": "1063456408",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UDS, INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2375 ST JOHNS BLUFF RD S",
"SecondLineMailingAddress": "STE 306",
"MailingAddressCityName": "JACKSONVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-721-2225",
"MailingAddressFaxNumber": "877-430-2291",
"FirstLinePracticeLocationAddress": "2375 ST JOHNS BLUFF RD S",
"SecondLinePracticeLocationAddress": "# 306",
"PracticeLocationAddressCityName": "JACKSONVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32246",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-721-2225",
"PracticeLocationAddressFaxNumber": "877-430-2291",
"EnumerationDate": "06/16/2006",
"LastUpdateDate": "04/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PESSOLANO",
"AuthorizedOfficialFirstName": "VINCE",
"AuthorizedOfficialMiddleName": "CARL",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "III",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "904-721-2225",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": "1729",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}