{
"Npi": {
"NPI": "1295181188",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "VELEZ VELEZ",
"FirstName": "JOSE",
"MiddleName": "GABRIEL",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "M.D.",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 687",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN GERMAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00683-0687",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-673-9980",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "EDIFICIO PLAZA METROPOLITANA, C, LIC HERNAN ALVAREZ",
"SecondLinePracticeLocationAddress": "SUITE 208",
"PracticeLocationAddressCityName": "SAN GERMAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00683",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-673-9980",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/10/2016",
"LastUpdateDate": "05/31/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2084N0600X",
"TaxonomyName": "Clinical Neurophysiology Physician",
"LicenseNumber": "21172",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "2084N0400X",
"TaxonomyName": "Neurology Physician",
"LicenseNumber": "21172",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}