{
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"FirstLineMailingAddress": "21229 OLEAN BLVD",
"SecondLineMailingAddress": "UNIT D",
"MailingAddressCityName": "PORT CHARLOTTE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33952-6719",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-625-6223",
"MailingAddressFaxNumber": "941-627-2680",
"FirstLinePracticeLocationAddress": "21229 OLEAN BLVD",
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"PracticeLocationAddressStateName": "FL",
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"PracticeLocationAddressTelephoneNumber": "941-625-6223",
"PracticeLocationAddressFaxNumber": "941-627-2680",
"EnumerationDate": "06/08/2011",
"LastUpdateDate": "12/02/2014",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POPPER",
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"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "941-625-6223",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RC0000X",
"TaxonomyName": "Cardiovascular Disease Physician",
"LicenseNumber": "ME46549",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}