{
"Npi": {
"NPI": "1659426583",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FLORIDA PEDORTHICS INCORPORATED",
"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": "1403 W BOYNTON BEACH BLVD",
"SecondLineMailingAddress": "SUITE 14-15",
"MailingAddressCityName": "BOYNTON BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33426",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-734-0032",
"MailingAddressFaxNumber": "561-734-5758",
"FirstLinePracticeLocationAddress": "1403 W BOYNTON BEACH BLVD",
"SecondLinePracticeLocationAddress": "SUITE 14-15",
"PracticeLocationAddressCityName": "BOYNTON BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33426",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-734-0032",
"PracticeLocationAddressFaxNumber": "561-734-5758",
"EnumerationDate": "01/23/2007",
"LastUpdateDate": "12/20/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAROCCA",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": "F",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CPED",
"AuthorizedOfficialTelephoneNumber": "561-734-0032",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BC3200X",
"TaxonomyName": "Customized Equipment (DME)",
"LicenseNumber": "PED20",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}