{
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"FirstLineMailingAddress": "9310 OLD KINGS RD S STE 1303",
"SecondLineMailingAddress": null,
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"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "9310 OLD KINGS RD SOUTH",
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"PracticeLocationAddressFaxNumber": "904-503-2373",
"EnumerationDate": "07/17/2013",
"LastUpdateDate": "08/12/2021",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CASTRO",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "ME101546",
"LicenseNumberStateCode": "FL",
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}
},
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}
}
}
}