{
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"FirstLineMailingAddress": "4634 SW 164TH CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33185-5198",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-474-7545",
"MailingAddressFaxNumber": "786-362-6128",
"FirstLinePracticeLocationAddress": "4634 SW 164TH CT",
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"PracticeLocationAddressCityName": "MIAMI",
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"PracticeLocationAddressTelephoneNumber": "786-474-7545",
"PracticeLocationAddressFaxNumber": "786-362-6128",
"EnumerationDate": "05/24/2016",
"LastUpdateDate": "03/25/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARENCIBIA",
"AuthorizedOfficialFirstName": "JUAN",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "REGISTERED BEHAVIORAL TECHNICIAN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "786-474-7545",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "RBT-15-01059",
"LicenseNumberStateCode": "FL",
"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."
}
}
}
}