{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 8085",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUMACAO",
"MailingAddressStateName": "PR",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-285-3919",
"MailingAddressFaxNumber": "787-285-3919",
"FirstLinePracticeLocationAddress": "AA3 AVE TEJAS",
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"PracticeLocationAddressCityName": "HUMACAO",
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"PracticeLocationAddressTelephoneNumber": "787-285-3919",
"PracticeLocationAddressFaxNumber": "787-285-3919",
"EnumerationDate": "08/08/2012",
"LastUpdateDate": "10/14/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FIGUEROA",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "787-285-3919",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "13148",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}