{
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"NamePrefix": null,
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"FirstLineMailingAddress": "4319 NEPTUNE ROAD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST CLOUD",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34769",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-498-0998",
"MailingAddressFaxNumber": "407-498-0988",
"FirstLinePracticeLocationAddress": "4319 NEPTUNE ROAD",
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"PracticeLocationAddressCityName": "ST CLOUD",
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"PracticeLocationAddressFaxNumber": "407-498-0988",
"EnumerationDate": "01/29/2016",
"LastUpdateDate": "03/02/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SUKH-GAFOOR",
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"AuthorizedOfficialCredential": "RN",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Assisted Living Facility",
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"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}