{
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"FirstLineMailingAddress": "PO BOX 39662",
"SecondLineMailingAddress": null,
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"MailingAddressStateName": "FL",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "CORNER CHANCELLOR & BLUE MARLIN AVENUES",
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"PracticeLocationAddressCityName": "BELIZE CITY",
"PracticeLocationAddressStateName": "BELIZE",
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"EnumerationDate": "02/09/2017",
"LastUpdateDate": "07/12/2017",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEAL",
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"AuthorizedOfficialTelephoneNumber": "954-526-9751",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}