{
"Npi": {
"NPI": "1376422626",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "BRUCH",
"FirstName": "PONDJULEE",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "LDO, AAS, ABOC, NCLE",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "6420 SE 42ND CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OCALA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34480-7757",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "484-560-3565",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4980 E SILVER SPRINGS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OCALA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34470-3268",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-236-1611",
"PracticeLocationAddressFaxNumber": "352-236-2378",
"EnumerationDate": "08/30/2025",
"LastUpdateDate": "08/30/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "156FX1800X",
"TaxonomyName": "Optician",
"LicenseNumber": "DO7380",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}