{
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"FirstLineMailingAddress": "917 BEVILLE RD STE B",
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"MailingAddressCityName": "SOUTH DAYTONA",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-481-1851",
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"FirstLinePracticeLocationAddress": "917 BEVILLE RD STE B",
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"PracticeLocationAddressCityName": "SOUTH DAYTONA",
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"EnumerationDate": "08/01/2022",
"LastUpdateDate": "08/01/2022",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "BROOMFIELD",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Health Aide",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}