{
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"FirstLineMailingAddress": "135-11 40TH ROAD",
"SecondLineMailingAddress": "SUITE 4A",
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"FirstLinePracticeLocationAddress": "13511 40TH RD STE 4A",
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"EnumerationDate": "08/17/2017",
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"AuthorizedOfficialLastName": "VO",
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"Taxonomies": {
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"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}