{
"Npi": {
"NPI": "1053127076",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "GOMEZ",
"FirstName": "LAZARO",
"MiddleName": "ALBERTO",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "16000 NW 38TH CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MIAMI GARDENS",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33054-6722",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "786-484-5042",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "16000 NW 38TH CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIAMI GARDENS",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33054-6722",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "786-484-5042",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/04/2024",
"LastUpdateDate": "01/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103K00000X",
"TaxonomyName": "Behavior Analyst",
"LicenseNumber": "RBT-24-396042",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}