{
"Npi": {
"NPI": "1699151563",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "WILLIAMS",
"FirstName": "CRYSTAL",
"MiddleName": "SHENAY",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "APRN",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4960 SW 72ND AVE STE 405",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33155-5506",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "469-458-9222",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "13945 N US HIGHWAY 441",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LADY LAKE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32159-8924",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-277-3500",
"PracticeLocationAddressFaxNumber": "352-277-3498",
"EnumerationDate": "08/03/2015",
"LastUpdateDate": "07/06/2026",
"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": "163W00000X",
"TaxonomyName": "Registered Nurse",
"LicenseNumber": "9493141",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "376K00000X",
"TaxonomyName": "Nurse's Aide",
"LicenseNumber": "196687",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363LF0000X",
"TaxonomyName": "Family Nurse Practitioner",
"LicenseNumber": "11035134",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}