{
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"NamePrefix": null,
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"FirstLineMailingAddress": "201 SE 15TH TER",
"SecondLineMailingAddress": "SUITE 212",
"MailingAddressCityName": "DEERFIELD BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33441-4464",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-642-1408",
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"FirstLinePracticeLocationAddress": "201 SE 15TH TER",
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"PracticeLocationAddressCityName": "DEERFIELD BEACH",
"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2015",
"LastUpdateDate": "03/04/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SPODAK",
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"AuthorizedOfficialCredential": "L.M.T., C.N.M.T",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MM11141",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}