{
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"FirstLineMailingAddress": "PO BOX 143613",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "305-856-2974",
"FirstLinePracticeLocationAddress": "3661 S MIAMI AVE",
"SecondLinePracticeLocationAddress": "SUITE 210",
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"EnumerationDate": "07/03/2006",
"LastUpdateDate": "08/22/2020",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "NODARSE",
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"AuthorizedOfficialCredential": "R. NCS T., R. EPT.",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "246ZE0600X",
"TaxonomyName": "Electroneurodiagnostic Specialist/Technologist",
"LicenseNumber": "NOT REQUIRED",
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"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."
}
}
}
}