{
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"EIN": null,
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"IsOrgSubpart": "N",
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"NamePrefix": null,
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"FirstLineMailingAddress": "701 E VIRGINIA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TAMPA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33603-5028",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-276-9828",
"MailingAddressFaxNumber": "813-276-9828",
"FirstLinePracticeLocationAddress": "701 E VIRGINIA AVE",
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"PracticeLocationAddressCityName": "TAMPA",
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"PracticeLocationAddressTelephoneNumber": "813-276-9828",
"PracticeLocationAddressFaxNumber": "813-276-9828",
"EnumerationDate": "07/02/2010",
"LastUpdateDate": "07/02/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEON",
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"AuthorizedOfficialTelephoneNumber": "813-610-4200",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "AL11572",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}