{
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"FirstLineMailingAddress": "2208 US HIGHWAY 19",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOLIDAY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34691-4351",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "727-382-7971",
"MailingAddressFaxNumber": "727-214-1215",
"FirstLinePracticeLocationAddress": "2208 US HIGHWAY 19",
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"PracticeLocationAddressCityName": "HOLIDAY",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressTelephoneNumber": "727-688-0290",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/22/2020",
"LastUpdateDate": "06/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAHANI",
"AuthorizedOfficialFirstName": "RAMI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "727-382-7971",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}