{
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"FirstLineMailingAddress": "37918 N COUNTY ROAD 44A",
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"MailingAddressCityName": "EUSTIS",
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"MailingAddressPostalCode": "32736-8329",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "320A W BURLEIGH BLVD",
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"PracticeLocationAddressCityName": "TAVARES",
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"PracticeLocationAddressFaxNumber": "352-742-3583",
"EnumerationDate": "01/15/2007",
"LastUpdateDate": "08/22/2020",
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"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "LADLEY",
"AuthorizedOfficialFirstName": "ROBERT",
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"AuthorizedOfficialCredential": "D.M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Endodontics",
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"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}