{
"Npi": {
"NPI": "1770764250",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SIMON ISAAC M D 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": "PO BOX 915259",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONGWOOD",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32791-5259",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-767-2996",
"MailingAddressFaxNumber": "407-767-0296",
"FirstLinePracticeLocationAddress": "448 S MILWEE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LONGWOOD",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32750-4163",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-767-2996",
"PracticeLocationAddressFaxNumber": "407-767-0296",
"EnumerationDate": "11/26/2007",
"LastUpdateDate": "03/20/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ISAAC",
"AuthorizedOfficialFirstName": "SIMON",
"AuthorizedOfficialMiddleName": "B",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "407-968-5218",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "ME95429",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}