{
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"FirstLineMailingAddress": "210 N GROVE ST",
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"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "321-449-8880",
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"FirstLinePracticeLocationAddress": "210 N GROVE ST",
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"PracticeLocationAddressCityName": "MERRITT ISLAND",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/13/2026",
"LastUpdateDate": "01/13/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARVAJAL",
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"AuthorizedOfficialTelephoneNumber": "305-428-2480",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}