{
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"FirstLineMailingAddress": "878 N MIRAMAR AVE",
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"MailingAddressCityName": "INDIALANTIC",
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"MailingAddressPostalCode": "32903-3054",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "321-506-4830",
"MailingAddressFaxNumber": "321-473-8744",
"FirstLinePracticeLocationAddress": "200 MIAMI AVE",
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"PracticeLocationAddressCityName": "INDIALANTIC",
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"PracticeLocationAddressFaxNumber": "321-473-8744",
"EnumerationDate": "10/03/2006",
"LastUpdateDate": "12/16/2013",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOPES",
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"AuthorizedOfficialCredential": "PT",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}