{
"Npi": {
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"EIN": null,
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"FirstLineMailingAddress": "PO BOX 100246",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALM BAY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32910-0246",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "321-952-7004",
"MailingAddressFaxNumber": "321-952-1004",
"FirstLinePracticeLocationAddress": "2060 PALM BAY RD NE",
"SecondLinePracticeLocationAddress": "SUITE 2",
"PracticeLocationAddressCityName": "PALM BAY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "321-952-7004",
"PracticeLocationAddressFaxNumber": "321-952-1004",
"EnumerationDate": "12/17/2007",
"LastUpdateDate": "12/17/2007",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH5958",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}