{
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"FirstLineMailingAddress": "3815 HARBOR DR",
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"MailingAddressCityName": "JACKSONVILLE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32207-2005",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "2570 ATLANTIC BLVD",
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"EnumerationDate": "11/10/2010",
"LastUpdateDate": "12/07/2023",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MATOS-GARSAULT",
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"AuthorizedOfficialCredential": "M.D.",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Pain Medicine (Anesthesiology) Physician",
"LicenseNumber": "ME89412",
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}
},
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}
}
}
}