{
"Npi": {
"NPI": "1528300548",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KOTADIA",
"FirstName": "SUJAL",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "38135 MARKET SQ",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ZEPHYRHILLS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33542-7505",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-528-4975",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6719 GALL BLVD STE 204",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ZEPHYRHILLS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33542-2569",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-782-1147",
"PracticeLocationAddressFaxNumber": "813-355-5056",
"EnumerationDate": "03/18/2013",
"LastUpdateDate": "12/20/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0800X",
"TaxonomyName": "Psychiatry Physician",
"LicenseNumber": "ME130876",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}