{
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"EIN": null,
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"ParentOrgLBN": null,
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"OrgName": "SOUTH FLORIDA SPINE AND CHIROPRACTIC CENTERS, LLC",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "8958 W. STATE ROAD 84",
"SecondLineMailingAddress": "PMB #179",
"MailingAddressCityName": "DAVIE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33324",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "954-913-4496",
"MailingAddressFaxNumber": "954-769-1970",
"FirstLinePracticeLocationAddress": "3111 N UNIVERSITY DR STE 402",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CORAL SPRINGS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33065-5033",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-913-4496",
"PracticeLocationAddressFaxNumber": "954-769-1970",
"EnumerationDate": "02/02/2022",
"LastUpdateDate": "02/02/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WESSLER",
"AuthorizedOfficialFirstName": "GREGG",
"AuthorizedOfficialMiddleName": "L.",
"AuthorizedOfficialTitle": "DOCTOR OF CHIROPRACTIC",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "954-913-4496",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}