{
"Npi": {
"NPI": "1306121553",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MEDHEALTH",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "METRO PLZ # 1801",
"SecondLineMailingAddress": "C/303 VILLAMIL",
"MailingAddressCityName": "SAN JUAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00907-2829",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-529-3102",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "EL AMAL PLAZA 282",
"SecondLinePracticeLocationAddress": "AVE JESUS T PINERO",
"PracticeLocationAddressCityName": "HATO REY",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00918",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-957-6225",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/19/2011",
"LastUpdateDate": "10/19/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALI-SHEHADEH",
"AuthorizedOfficialFirstName": "SAMAH",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "787-529-3102",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "15488",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}