{
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"FirstLineMailingAddress": "70 COUNTRY CLUB ROAD",
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"MailingAddressFaxNumber": "321-799-1177",
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"PracticeLocationAddressTelephoneNumber": "321-674-1605",
"PracticeLocationAddressFaxNumber": "321-674-1606",
"EnumerationDate": "10/19/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROY",
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"AuthorizedOfficialTelephoneNumber": "321-799-1278",
"Taxonomies": {
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{
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"TaxonomyName": "Hearing Instrument Specialist",
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
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}
]
}
}
}