{
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"FirstLineMailingAddress": "5201 HOLLYWOOD BLVD",
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"MailingAddressStateName": "FL",
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"FirstLinePracticeLocationAddress": "5201 HOLLYWOOD BLVD",
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"EnumerationDate": "03/17/2020",
"LastUpdateDate": "02/05/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONZALEZ",
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"AuthorizedOfficialCredential": "MD",
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"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}