{
"Npi": {
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JAYNE KWIATKOWSKI LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1414 W GRANADA BLVD STE 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORMOND BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32174-8104",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-872-5323",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1414 W GRANADA BLVD STE 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ORMOND BEACH",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "386-872-5323",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/28/2014",
"LastUpdateDate": "02/26/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KWIATKOWSKI",
"AuthorizedOfficialFirstName": "JAYNE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/MGR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "386-872-5323",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "CH9417",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}