{
"Npi": {
"NPI": "1881968451",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTH POINT INJURY CENTER, 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": "6817 SOUTHPOINT PKWY",
"SecondLineMailingAddress": "SUITE 2303",
"MailingAddressCityName": "JACKSONVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32216-6282",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-683-3205",
"MailingAddressFaxNumber": "904-683-3384",
"FirstLinePracticeLocationAddress": "6817 SOUTHPOINT PKWY",
"SecondLinePracticeLocationAddress": "SUITE 2303",
"PracticeLocationAddressCityName": "JACKSONVILLE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32216-6282",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-683-3205",
"PracticeLocationAddressFaxNumber": "904-683-3384",
"EnumerationDate": "02/29/2012",
"LastUpdateDate": "02/29/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DE LA PENA",
"AuthorizedOfficialFirstName": "JESSIE",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "MASSAGE THERAPY",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LMT",
"AuthorizedOfficialTelephoneNumber": "904-683-3205",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "HCC9772",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}