{
"Npi": {
"NPI": "1073610366",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFE AMBULANCE SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"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": "PO BOX 2262",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GUAYAMA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00785-2262",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-864-7806",
"MailingAddressFaxNumber": "787-864-7806",
"FirstLinePracticeLocationAddress": "CARRETERA #15 KM. 0.3",
"SecondLinePracticeLocationAddress": "SALIDA A CAYEY",
"PracticeLocationAddressCityName": "GUAYAMA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00784",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-864-7806",
"PracticeLocationAddressFaxNumber": "787-864-7806",
"EnumerationDate": "09/20/2006",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEREZ",
"AuthorizedOfficialFirstName": "REINALDO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-864-7806",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "TCAMB029",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}