{
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"FirstLineMailingAddress": "1430 PALM BAY RD NE",
"SecondLineMailingAddress": "SUITE C",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1430 PALM BAY RD NE",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": "321-952-0848",
"EnumerationDate": "08/08/2007",
"LastUpdateDate": "01/29/2010",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOMACK",
"AuthorizedOfficialFirstName": "MICHAEL",
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"AuthorizedOfficialCredential": "DC",
"AuthorizedOfficialTelephoneNumber": "321-723-2113",
"Taxonomies": {
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{
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},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": {
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},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}