{
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"EIN": null,
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"FirstLineMailingAddress": "5135 TOKEN TRL",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-971-1072",
"MailingAddressFaxNumber": "407-977-3630",
"FirstLinePracticeLocationAddress": "3400 QUADRANGLE BLVD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-384-1044",
"PracticeLocationAddressFaxNumber": "407-977-3630",
"EnumerationDate": "01/05/2007",
"LastUpdateDate": "07/08/2007",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Marriage & Family Therapist",
"LicenseNumber": "MT-1706",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}