{
"Npi": {
"NPI": "1174895726",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ITURREGUI REHAB CENTER CSP",
"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 2809",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAYAMON",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00960-2809",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-757-2146",
"MailingAddressFaxNumber": "787-757-2146",
"FirstLinePracticeLocationAddress": "SANTURCE MEDICAL MALL",
"SecondLinePracticeLocationAddress": "AVE PONCE DE LEON 1801 SUITE 312",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00909-0000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-757-2146",
"PracticeLocationAddressFaxNumber": "787-757-2146",
"EnumerationDate": "01/29/2012",
"LastUpdateDate": "02/11/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OTERO",
"AuthorizedOfficialFirstName": "MILAGROS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "P.T.",
"AuthorizedOfficialTelephoneNumber": "787-757-2146",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2000X",
"TaxonomyName": "Physical Therapy Clinic/Center",
"LicenseNumber": "730",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}