{
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"FirstLineMailingAddress": "10907 SW 88TH ST APT 423",
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"FirstLinePracticeLocationAddress": "640 W PALM DR STE D",
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"PracticeLocationAddressCityName": "FLORIDA CITY",
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"EnumerationDate": "09/19/2022",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
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"LicenseNumber": "CBHCM.0104285",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}