{
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"OrgName": "CHIROMEDIC SERVICES OF N.M.B, INC",
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"FirstLineMailingAddress": "16932 NE 19TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH MIAMI BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33162-3110",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-201-2778",
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"FirstLinePracticeLocationAddress": "16932 NE 19TH AVE",
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"PracticeLocationAddressCityName": "NORTH MIAMI BEACH",
"PracticeLocationAddressStateName": "FL",
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"EnumerationDate": "01/30/2012",
"LastUpdateDate": "02/29/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GUADAGNO",
"AuthorizedOfficialFirstName": "PAUL",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "786-657-3242",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111NR0400X",
"TaxonomyName": "Rehabilitation Chiropractor",
"LicenseNumber": "CH9004",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"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."
}
}
}
}