{
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"FirstLineMailingAddress": "8200 NW 41ST STREET",
"SecondLineMailingAddress": "2ND FLOOR, STE 40",
"MailingAddressCityName": "DORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33166",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-344-4173",
"MailingAddressFaxNumber": "786-364-1861",
"FirstLinePracticeLocationAddress": "8200 NW 41ST STREET",
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"PracticeLocationAddressCityName": "DORAL",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "786-344-4173",
"PracticeLocationAddressFaxNumber": "786-364-1861",
"EnumerationDate": "02/23/2018",
"LastUpdateDate": "05/26/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FRAGA MEDEROS",
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"AuthorizedOfficialMiddleName": "KARLA",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "786-344-4173",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}