{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "376 NORTHLAKE BLVD STE 1008",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALTAMONTE SPRINGS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32701-5261",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "888-292-0744",
"MailingAddressFaxNumber": "833-670-2942",
"FirstLinePracticeLocationAddress": "4690 CARPINTERIA AVE STE B",
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"PracticeLocationAddressCityName": "CARPINTERIA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "93013-1875",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "805-770-2061",
"PracticeLocationAddressFaxNumber": "805-456-0416",
"EnumerationDate": "08/16/2013",
"LastUpdateDate": "08/09/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTANEZ",
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"AuthorizedOfficialTelephoneNumber": "888-292-0744",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336H0001X",
"TaxonomyName": "Home Infusion Therapy Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}