{
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"FirstLinePracticeLocationAddress": "2400 N BULLARD AVE APT 1095",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GOODYEAR",
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"PracticeLocationAddressTelephoneNumber": "352-678-8554",
"PracticeLocationAddressFaxNumber": "352-678-8554",
"EnumerationDate": "01/06/2020",
"LastUpdateDate": "01/06/2020",
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"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
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"Taxonomies": {
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{
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"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "101YP1600X",
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}