{
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"OtherLastName": "HAYNES",
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"OtherCredential": "HEART OF GOLD AGENCY",
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"FirstLineMailingAddress": "6249 EDGEWATER DR # V1",
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"MailingAddressCityName": "ORLANDO",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": "844-388-0438",
"FirstLinePracticeLocationAddress": "410 SUNNYVIEW CIR",
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"PracticeLocationAddressCityName": "ORLANDO",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/28/2020",
"LastUpdateDate": "12/13/2022",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}