{"npi":"1710348479","type":"NPI-1","status":"active","name":{"display":"Katrina Potithavoranant","other":[],"first":"KATRINA","last":"POTITHAVORANANT"},"specialty":{"primary_taxonomy":"363AM0700X","primary_taxonomy_description":"Medical Physician Assistant","slug":"medical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AM0700X","description":"Medical Physician Assistant","primary":true,"state":"FL","license":"PA9112237"}]},"addresses":[{"purpose":"LOCATION","street_1":"620 10TH ST N STE 1E","city":"SAINT PETERSBURG","state":"FL","postal_code":"337051407","country_code":"US","phone":"7278243120"},{"purpose":"MAILING","street_1":"620 10TH ST N STE 1E","city":"SAINT PETERSBURG","state":"FL","postal_code":"337051407","country_code":"US","phone":"7278243120"}],"license":{"state":"FL","number":"PA9112237"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"104661300","state":"FL","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20200116002286","type_code":"14-97","type_desc":"PRACTITIONER - PHYSICIAN ASSISTANT","state":"FL","pac_id":"1052610425"}]},"enumeration_date":"2016-03-09","last_updated":"2023-08-17","_meta":{"source":"NPPES","snapshot_date":"2023-08-17","doc_url":"https://findmynpi.com/api"}}