{
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"EIN": null,
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"OrgName": "V.I.P. AMBULANCE CORPORATION",
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"FirstLineMailingAddress": "PO BOX 29004",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN JUAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00929-0004",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-708-4558",
"MailingAddressFaxNumber": "787-790-9212",
"FirstLinePracticeLocationAddress": "180 CALLE JOSE F DIAZ",
"SecondLinePracticeLocationAddress": "APTO 1502 COND MONTE BRISAS",
"PracticeLocationAddressCityName": "SAN JUAN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-708-4558",
"PracticeLocationAddressFaxNumber": "787-731-2711",
"EnumerationDate": "05/27/2006",
"LastUpdateDate": "08/16/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANTIAGO",
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"AuthorizedOfficialTelephoneNumber": "787-708-4558",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Land Ambulance",
"LicenseNumber": "TCAMB313",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}