{
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"FirstLineMailingAddress": "4506 EDMONDSON AVE",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-566-5565",
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"EnumerationDate": "10/18/2012",
"LastUpdateDate": "05/24/2021",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEDAVEETI",
"AuthorizedOfficialFirstName": "PRUDVI RAM REDDY",
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"Taxonomies": {
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{
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},
{
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}
]
},
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}
}