{
"Npi": {
"NPI": "1952526329",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "TUFARIELLO",
"FirstName": "MARISSA",
"MiddleName": "BROOKE",
"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7601 DR. MLK JR. ST. N.",
"SecondLineMailingAddress": "SUITE C-2",
"MailingAddressCityName": "ST. PETERSBURG",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33702",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-527-2888",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2863 ALT. 19 N.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PALM HARBOR",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34683-1926",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-781-5652",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/13/2007",
"LastUpdateDate": "10/15/2012",
"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": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "009672",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "PA9105412",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}