{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
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"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "10907 E US HIGHWAY 92 STE D",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SEFFNER",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33584-3231",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-405-8900",
"MailingAddressFaxNumber": "813-614-9133",
"FirstLinePracticeLocationAddress": "10907 E US HIGHWAY 92 STE D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SEFFNER",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-405-8900",
"PracticeLocationAddressFaxNumber": "813-614-9133",
"EnumerationDate": "10/21/2016",
"LastUpdateDate": "02/21/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ZAYED",
"AuthorizedOfficialFirstName": "MOHAMMAD",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/PHARMACIST",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-405-8900",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
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"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}