{
"Npi": {
"NPI": "1306176904",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
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"ParentOrgLBN": null,
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"NamePrefix": "MRS.",
"NameSuffix": null,
"Credential": "LMT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "OTERO",
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"OtherCredential": "LMT",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "1621 SW OPEN SANDS LOOP",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32331-3615",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "850-948-2999",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "348 N FLETCHER AVE",
"SecondLinePracticeLocationAddress": "HIGHWAY 51 NORTH",
"PracticeLocationAddressCityName": "MAYO",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32066-4502",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "386-294-2346",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/04/2010",
"LastUpdateDate": "01/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
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"AuthorizedOfficialTitle": null,
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MA39314",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}