{
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"FirstLineMailingAddress": "PO BOX 2559",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "617 23RD ST",
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"EnumerationDate": "03/29/2007",
"LastUpdateDate": "10/24/2007",
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"AuthorizedOfficialLastName": "MARTINEZ",
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"Taxonomies": {
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"TaxonomyName": "Specialist",
"LicenseNumber": "36468",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}