{
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"FirstLineMailingAddress": "102 S PENINSULA DR",
"SecondLineMailingAddress": "UNIT 208",
"MailingAddressCityName": "DAYTONA BEACH",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "102 S PENINSULA DR",
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"PracticeLocationAddressTelephoneNumber": "386-589-7332",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/06/2009",
"LastUpdateDate": "11/06/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Occupational Therapist",
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"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}