{
"Npi": {
"NPI": "1942080635",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "HOUCK",
"FirstName": "KAYLA",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CARFAGNO",
"OtherFirstName": "KAYLA",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "6406 BROOK VILLAGE CV APT 108",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRADENTON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34202-2732",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-687-2406",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "14605 SR 70-E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKEWOOD RANCH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-253-1004",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/02/2023",
"LastUpdateDate": "10/02/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "183500000X",
"TaxonomyName": "Pharmacist",
"LicenseNumber": "PS66430",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}