{
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"FirstLineMailingAddress": "75-127 LUNAPULE RD STE 7E",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "75-127 LUNAPULE RD STE 7E",
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"EnumerationDate": "04/14/2025",
"LastUpdateDate": "04/14/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ACOSTA",
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{
"TaxonomyCode": "251E00000X",
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},
{
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}
]
},
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}
}