{
"Npi": {
"NPI": "1235224585",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADOLFO AVILES",
"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": "65 CALLE 65 INFANTERIA",
"SecondLineMailingAddress": "SUITE 208",
"MailingAddressCityName": "ANASCO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00610-2909",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-826-0770",
"MailingAddressFaxNumber": "787-895-4630",
"FirstLinePracticeLocationAddress": "65 CALLE 65 INFANTERIA",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "ANASCO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00610-2909",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-826-0770",
"PracticeLocationAddressFaxNumber": "787-895-4630",
"EnumerationDate": "10/03/2006",
"LastUpdateDate": "07/13/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AVILES",
"AuthorizedOfficialFirstName": "ADOLFO",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-826-0770",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "TC-AMB-201",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}