{
"Npi": {
"NPI": "1962709899",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AMBERLY PARADOA DPM PA",
"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": "3735 11TH CIR",
"SecondLineMailingAddress": "SUITE 201",
"MailingAddressCityName": "VERO BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32960-4844",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-299-7009",
"MailingAddressFaxNumber": "772-568-7138",
"FirstLinePracticeLocationAddress": "1627 US HIGHWAY 1",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "SEBASTIAN",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32958-3899",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-589-9970",
"PracticeLocationAddressFaxNumber": "772-589-9939",
"EnumerationDate": "02/11/2011",
"LastUpdateDate": "02/11/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARADOA",
"AuthorizedOfficialFirstName": "AMBERLY",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "772-299-7009",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": "PO3105",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}