{
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"FirstLineMailingAddress": "6105 GRAND CYPRESS CIR E",
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"MailingAddressStateName": "FL",
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"FirstLinePracticeLocationAddress": "12890 PINES BLVD",
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"EnumerationDate": "11/21/2022",
"LastUpdateDate": "11/21/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "LAWRENCE",
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"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialTelephoneNumber": "954-647-8721",
"Taxonomies": {
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"TaxonomyName": "Optometrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}