{
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"FirstLineMailingAddress": "363 ATLANTIC BLVD STE 12",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-242-0800",
"MailingAddressFaxNumber": "904-242-0800",
"FirstLinePracticeLocationAddress": "363 ATLANTIC BLVD STE 12",
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"PracticeLocationAddressFaxNumber": "904-242-0800",
"EnumerationDate": "12/10/2007",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FETTIG",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}