{
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"EIN": null,
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"FirstLineMailingAddress": "5230 N ORANGE BLOSSOM TRL",
"SecondLineMailingAddress": "#306",
"MailingAddressCityName": "ORLANDO",
"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5230 N ORANGE BLOSSOM TRL",
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"PracticeLocationAddressTelephoneNumber": "407-926-5006",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/10/2007",
"LastUpdateDate": "07/08/2007",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332B00000X",
"TaxonomyName": "Durable Medical Equipment & Medical Supplies",
"LicenseNumber": null,
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}