{
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"FirstLineMailingAddress": "11010 POINT NELLIE DR",
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"MailingAddressCityName": "CLERMONT",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34711-8663",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "192 W HWY 50",
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"EnumerationDate": "10/06/2015",
"LastUpdateDate": "02/01/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PORTELA-BERRIOS",
"AuthorizedOfficialFirstName": "JOSE",
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"AuthorizedOfficialCredential": "D.C.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "CH11376",
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"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."
}
}
}
}