{
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"FirstLineMailingAddress": "PO BOX 1743",
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"FirstLinePracticeLocationAddress": "1624 I ST",
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"EnumerationDate": "12/13/2009",
"LastUpdateDate": "09/18/2012",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PORTILLO",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}