{
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"FirstLineMailingAddress": "1411 S 14TH ST",
"SecondLineMailingAddress": "SUITE G",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1411 S 14TH ST",
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"EnumerationDate": "06/16/2014",
"LastUpdateDate": "09/12/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOSS",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Corneal and Contact Management Optometrist",
"LicenseNumber": "OPC4033",
"LicenseNumberStateCode": "FL",
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}
},
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}
}
}
}