{
"Npi": {
"NPI": "1922370485",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BAYSIDE HEARING AID CENTER INC",
"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": "16450 SAN CARLOS BLVD STE 3",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT MYERS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33908-3271",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "239-415-0727",
"MailingAddressFaxNumber": "239-288-4915",
"FirstLinePracticeLocationAddress": "16450 SAN CARLOS BLVD STE 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FORT MYERS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33908-3271",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "239-415-0727",
"PracticeLocationAddressFaxNumber": "239-288-4915",
"EnumerationDate": "01/31/2012",
"LastUpdateDate": "01/31/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WINN",
"AuthorizedOfficialFirstName": "ELEANOR",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "AS BCHIS ACA",
"AuthorizedOfficialTelephoneNumber": "239-415-0727",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332S00000X",
"TaxonomyName": "Hearing Aid Equipment",
"LicenseNumber": "AS2687",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}