{
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"FirstLineMailingAddress": "208 N HALIFAX AVE",
"SecondLineMailingAddress": "SUITE1",
"MailingAddressCityName": "DAYTONA BEACH",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-677-5415",
"MailingAddressFaxNumber": "386-677-1475",
"FirstLinePracticeLocationAddress": "1702 RIDGEWOOD AVE",
"SecondLinePracticeLocationAddress": "SUITE I",
"PracticeLocationAddressCityName": "HOLLY HILL",
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"PracticeLocationAddressTelephoneNumber": "386-677-5415",
"PracticeLocationAddressFaxNumber": "386-677-1475",
"EnumerationDate": "12/16/2013",
"LastUpdateDate": "04/23/2014",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIKULA",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}