{
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"FirstLineMailingAddress": "PO BOX 821807",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PEMBROKE PINES",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33082-1807",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "754-300-1977",
"MailingAddressFaxNumber": "954-272-7638",
"FirstLinePracticeLocationAddress": "7351 WEST OAKLAND PARK BLVD",
"SecondLinePracticeLocationAddress": "SUITE 105",
"PracticeLocationAddressCityName": "LAUDERHILL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "754-300-1977",
"PracticeLocationAddressFaxNumber": "954-272-7638",
"EnumerationDate": "06/15/2017",
"LastUpdateDate": "03/20/2019",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "STEVEN",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialCredential": "DO",
"AuthorizedOfficialTelephoneNumber": "754-300-1977",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Infectious Disease Physician",
"LicenseNumber": "OS12899",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}