{
"Npi": {
"NPI": "1679757918",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR ALAN H SIEGEL P A",
"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": "10692 S US HIGHWAY 1",
"SecondLineMailingAddress": "SUITE B",
"MailingAddressCityName": "PORT ST LUCIE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34952-6408",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-335-5006",
"MailingAddressFaxNumber": "772-335-4672",
"FirstLinePracticeLocationAddress": "10692 S US HIGHWAY 1",
"SecondLinePracticeLocationAddress": "SUITE B",
"PracticeLocationAddressCityName": "PORT ST LUCIE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34952-6408",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-335-5006",
"PracticeLocationAddressFaxNumber": "772-335-4672",
"EnumerationDate": "12/21/2007",
"LastUpdateDate": "10/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIEGEL",
"AuthorizedOfficialFirstName": "ALAN",
"AuthorizedOfficialMiddleName": "HOWARD",
"AuthorizedOfficialTitle": "OPTOMETRIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "O.D.",
"AuthorizedOfficialTelephoneNumber": "772-335-5006",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "332H00000X",
"TaxonomyName": "Eyewear Supplier",
"LicenseNumber": "FL1190",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "152W00000X",
"TaxonomyName": "Optometrist",
"LicenseNumber": "OPC1190",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}