{
"Npi": {
"NPI": "1689682262",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SIEDLACK",
"FirstName": "VICKI",
"MiddleName": null,
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "N.P",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "14050 NW 14TH ST",
"SecondLineMailingAddress": "SUITE 190",
"MailingAddressCityName": "SUNRISE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33323-2865",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-424-3672",
"MailingAddressFaxNumber": "954-377-3042",
"FirstLinePracticeLocationAddress": "4016 SUN CITY CENTER BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SUN CITY CENTER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33573-5256",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-634-3301",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/03/2006",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363L00000X",
"TaxonomyName": "Nurse Practitioner",
"LicenseNumber": "ARNP3099632",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}