{
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"FirstLineMailingAddress": "11924 W FOREST HILL BLVD",
"SecondLineMailingAddress": "SUITE 22-313",
"MailingAddressCityName": "WELLINGTON",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33414-6256",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-784-1933",
"MailingAddressFaxNumber": "561-784-5109",
"FirstLinePracticeLocationAddress": "10131 W FOREST HILL BLVD",
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"PracticeLocationAddressCityName": "WELLINGTON",
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"PracticeLocationAddressFaxNumber": "561-784-5109",
"EnumerationDate": "02/21/2006",
"LastUpdateDate": "07/15/2009",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BERNSTEIN",
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"AuthorizedOfficialTitle": "MANAGING MEMBER",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "561-784-1933",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207V00000X",
"TaxonomyName": "Obstetrics & Gynecology Physician",
"LicenseNumber": "ME 79627",
"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."
}
}
}
}