{
"Npi": {
"NPI": "1942514443",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DR ALEXIS BERGAN-GUZMAN DC PA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherMiddleName": null,
"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "671 NW 89TH AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANTATION",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33324-6108",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-850-0704",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "116 NW 5TH STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CRYSTAL RIVER",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34428",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-850-0704",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/27/2010",
"LastUpdateDate": "07/27/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BERGAN-GUZMAN",
"AuthorizedOfficialFirstName": "ALEXIS",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "954-850-0704",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "111N00000X",
"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH9941",
"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."
}
}
}
}