{
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"FirstLineMailingAddress": "101 S FEDERAL HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DANIA BEACH",
"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-833-8591",
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"FirstLinePracticeLocationAddress": "101 S FEDERAL HWY",
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"PracticeLocationAddressCityName": "DANIA BEACH",
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"EnumerationDate": "05/23/2016",
"LastUpdateDate": "02/21/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRAVO",
"AuthorizedOfficialFirstName": "CARLOS",
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"AuthorizedOfficialTelephoneNumber": "786-660-0350",
"Taxonomies": {
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"TaxonomyName": "Behavior Analyst",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}