{
"Npi": {
"NPI": "1114103801",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BENJAMIN AVILES MELENDEZ",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "HC 2 BOX 6532",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOROVIS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00687",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-369-5572",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "CARR. 6622 KM. 7 SECTOR LA LINEA",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MOROVIS",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00687",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-369-5572",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/14/2008",
"LastUpdateDate": "02/14/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AVILES",
"AuthorizedOfficialFirstName": "BENJAMIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-369-5572",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "TC-AMB 512",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}