{
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"FirstLineMailingAddress": "4114 SUNBEAM RD",
"SecondLineMailingAddress": "BUILDING 100, SUITE 102",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-880-1400",
"MailingAddressFaxNumber": "904-886-4433",
"FirstLinePracticeLocationAddress": "4114 SUNBEAM RD",
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"PracticeLocationAddressFaxNumber": "904-886-4433",
"EnumerationDate": "07/28/2014",
"LastUpdateDate": "07/28/2014",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "LONDON",
"AuthorizedOfficialFirstName": "BEVERLY",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
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"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "ME0073682",
"LicenseNumberStateCode": "FL",
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}
},
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}
}
}
}