{
"Npi": {
"NPI": "1225005457",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FLORES",
"FirstName": "SUSAN",
"MiddleName": "G",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "GUMABAO-FLORES",
"OtherFirstName": "SUSAN",
"OtherMiddleName": null,
"OtherNamePrefix": "MRS.",
"OtherNameSuffix": null,
"OtherCredential": "MD",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "20525 CENTER RIDGE RD",
"SecondLineMailingAddress": "STE 220",
"MailingAddressCityName": "ROCKY RIVER",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44116",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-895-5056",
"MailingAddressFaxNumber": "440-333-2935",
"FirstLinePracticeLocationAddress": "1730 W 25TH ST",
"SecondLinePracticeLocationAddress": "MAIN FLOOR",
"PracticeLocationAddressCityName": "CLEVELAND",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44113",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-363-2353",
"PracticeLocationAddressFaxNumber": "216-696-7375",
"EnumerationDate": "03/07/2006",
"LastUpdateDate": "05/27/2008",
"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": "207R00000X",
"TaxonomyName": "Internal Medicine Physician",
"LicenseNumber": "35044831F",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}