{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMACIA GABRIELA INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 801214",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COTO LAUREL",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00780-1214",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-260-2700",
"MailingAddressFaxNumber": "787-837-2100",
"FirstLinePracticeLocationAddress": "CARRETERA 14 KM 11.1 BO COLLORES SECTOR CAYABO",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JUANA DIAZ",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00795",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-260-2700",
"PracticeLocationAddressFaxNumber": "787-837-2100",
"EnumerationDate": "05/09/2008",
"LastUpdateDate": "05/12/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BANCHS",
"AuthorizedOfficialFirstName": "LIZ ANN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-391-3056",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "17F2554",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}