{
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"FirstLineMailingAddress": "9766 SW 24TH ST STE 6",
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"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33165-7575",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-995-0542",
"MailingAddressFaxNumber": "305-995-0543",
"FirstLinePracticeLocationAddress": "9766 SW 24TH ST STE 6",
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"PracticeLocationAddressCityName": "MIAMI",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-995-0542",
"PracticeLocationAddressFaxNumber": "305-995-0543",
"EnumerationDate": "09/08/2019",
"LastUpdateDate": "04/30/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HERRERA CASAS",
"AuthorizedOfficialFirstName": "SUNILDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.D.S.",
"AuthorizedOfficialTelephoneNumber": "786-502-6733",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "1223G0001X",
"TaxonomyName": "General Practice Dentistry",
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"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}