{
"Npi": {
"NPI": "1841748415",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JNISSI SIGNATURE COLLECTION",
"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": "435 NE 171ST TER",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NORTH MIAMI BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33162-3914",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-617-2606",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "435 NE 171ST TER",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NORTH MIAMI BEACH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33162-3914",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "786-617-2606",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/13/2016",
"LastUpdateDate": "09/13/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JEAN",
"AuthorizedOfficialFirstName": "VENECIA",
"AuthorizedOfficialMiddleName": "LASALLE",
"AuthorizedOfficialTitle": "CRANIAL PROSTHESIS SPECILAIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "786-617-2606",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}