{
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"EIN": null,
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"OrgName": "CITRUS PODIATRY CENTER PA",
"LastName": null,
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"NamePrefix": null,
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"Credential": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1120",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LECANTO",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34460-1120",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "352-746-0077",
"MailingAddressFaxNumber": "352-746-1704",
"FirstLinePracticeLocationAddress": "2385 N LECANTO HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LECANTO",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34461",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "352-746-0077",
"PracticeLocationAddressFaxNumber": "352-746-1704",
"EnumerationDate": "01/26/2006",
"LastUpdateDate": "01/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DALY",
"AuthorizedOfficialFirstName": "EDWARD",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "BUSINESS OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DPM",
"AuthorizedOfficialTelephoneNumber": "352-746-0077",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "213E00000X",
"TaxonomyName": "Podiatrist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}