{
"Npi": {
"NPI": "1689820326",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ST PETE SPINAL CARE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6798 CROSSWINDS DR N",
"SecondLineMailingAddress": "C105",
"MailingAddressCityName": "ST PETERSBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33710-8603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-344-2225",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "6798 CROSSWINDS DR N",
"SecondLinePracticeLocationAddress": "C105",
"PracticeLocationAddressCityName": "ST PETERSBURG",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33710-8603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-344-2225",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/13/2008",
"LastUpdateDate": "08/13/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRIMMEL",
"AuthorizedOfficialFirstName": "STANLEY",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "727-344-2225",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "CH9471",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}