{
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"FirstLineMailingAddress": "PO BOX 994",
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"MailingAddressCityName": "INDIAN ROCKS BEACH",
"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "19811 GULF BLVD",
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"EnumerationDate": "08/16/2016",
"LastUpdateDate": "08/16/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAJOR",
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"Taxonomies": {
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"LicenseNumber": "53616",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}