{
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "211 NE 89TH ST",
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"PracticeLocationAddressCityName": "EL PORTAL",
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"EnumerationDate": "07/10/2019",
"LastUpdateDate": "03/16/2023",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
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"Gender": null,
"AuthorizedOfficialLastName": "ALVAREZ",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}