{
"Npi": {
"NPI": "1356126684",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "NOGUERA",
"FirstName": "GLORIMAR",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.S., CCC-SLP",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "ALTS DE HATO NUEVO 454",
"SecondLineMailingAddress": "CALLE RIO LOCO",
"MailingAddressCityName": "GURABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00778-8458",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-321-0760",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1441 SW 1ST ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33135-2202",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-541-3400",
"PracticeLocationAddressFaxNumber": "305-541-3344",
"EnumerationDate": "08/25/2023",
"LastUpdateDate": "08/20/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2355S0801X",
"TaxonomyName": "Speech-Language Assistant",
"LicenseNumber": "SI6556",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "SA22894",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}