{
"Npi": {
"NPI": "1770830747",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ORLANDO ACUPUNCTURE AND WELLNESS, LLC",
"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": "1922 BONANZA CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WINTER PARK",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32792-2026",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-993-0994",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "300 WILSHIRE BLVD",
"SecondLinePracticeLocationAddress": "SUITE 237",
"PracticeLocationAddressCityName": "CASSELBERRY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32707-5378",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-993-0994",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/09/2012",
"LastUpdateDate": "08/09/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRADY",
"AuthorizedOfficialFirstName": "NEAL",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "ACUPUNCTURIST",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.AC.",
"AuthorizedOfficialTelephoneNumber": "954-993-0994",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171100000X",
"TaxonomyName": "Acupuncturist",
"LicenseNumber": "AP2300",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"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."
}
}
}
}