{
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"EIN": null,
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "1039 HARLEY STRICKLAND BLVD STE 700",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORANGE CITY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32763-7981",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "386-532-0220",
"MailingAddressFaxNumber": "386-532-0283",
"FirstLinePracticeLocationAddress": "1039 HARLEY STRICKLAND BLVD STE 700",
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"PracticeLocationAddressCityName": "ORANGE CITY",
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"PracticeLocationAddressTelephoneNumber": "386-532-0220",
"PracticeLocationAddressFaxNumber": "386-532-0283",
"EnumerationDate": "02/20/2024",
"LastUpdateDate": "02/20/2024",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PATEL",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "386-532-0220",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336L0003X",
"TaxonomyName": "Long Term Care Pharmacy",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}