{
"Npi": {
"NPI": "1255376497",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMBITRANS MEDICAL TRANSPORT , INC.",
"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": "4351 PINNACLE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORT CHARLOTTE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33980-2902",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-743-3665",
"MailingAddressFaxNumber": "941-629-7314",
"FirstLinePracticeLocationAddress": "4351 PINNACLE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT CHARLOTTE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33980-2902",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-743-3665",
"PracticeLocationAddressFaxNumber": "941-629-2193",
"EnumerationDate": "06/19/2006",
"LastUpdateDate": "09/14/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SKAVRONECK",
"AuthorizedOfficialFirstName": "ALAN",
"AuthorizedOfficialMiddleName": "J.",
"AuthorizedOfficialTitle": "CHIEF OPERATING OFFICER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "941-613-6427",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "2639",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "ALS0804",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}