{
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"FirstLineMailingAddress": "6272 LAKE OSPREY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LAKEWOOD RANCH",
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"MailingAddressPostalCode": "34240-8425",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-666-8757",
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"FirstLinePracticeLocationAddress": "6272 LAKE OSPREY DR",
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"PracticeLocationAddressCityName": "LAKEWOOD RANCH",
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"PracticeLocationAddressFaxNumber": "941-348-1421",
"EnumerationDate": "07/27/2016",
"LastUpdateDate": "02/22/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PORTER",
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"AuthorizedOfficialTitle": "PRACTICE OWNER",
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"AuthorizedOfficialCredential": "D.O",
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"Taxonomies": {
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"TaxonomyName": "Primary Care Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}