{
"Npi": {
"NPI": "1144527722",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "SANTIAGO",
"FirstName": "GLENDA",
"MiddleName": "LEE",
"NamePrefix": "MS.",
"NameSuffix": null,
"Credential": "L.M.T.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CABAN",
"OtherFirstName": "GLENDA",
"OtherMiddleName": "LEE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "1802 E ESKIMO AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TAMPA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33604-2020",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-378-1184",
"MailingAddressFaxNumber": "727-233-6294",
"FirstLinePracticeLocationAddress": "10622 DEVCO DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PORT RICHEY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34668-2871",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "727-233-2025",
"PracticeLocationAddressFaxNumber": "727-233-6294",
"EnumerationDate": "02/17/2011",
"LastUpdateDate": "05/30/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "225700000X",
"TaxonomyName": "Massage Therapist",
"LicenseNumber": "MA 61731",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}