{
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"OrgName": "AFFILIATES IN DIGESTIVE & LIVER DISEASES, P.A.",
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"NamePrefix": null,
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"FirstLineMailingAddress": "5508 OCEAN DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CORPUS CHRISTI",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78412-2750",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "361-215-3285",
"MailingAddressFaxNumber": "361-906-0125",
"FirstLinePracticeLocationAddress": "5508 OCEAN DR",
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"PracticeLocationAddressCityName": "CORPUS CHRISTI",
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"PracticeLocationAddressTelephoneNumber": "361-215-3285",
"PracticeLocationAddressFaxNumber": "361-906-0125",
"EnumerationDate": "05/24/2007",
"LastUpdateDate": "06/15/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PEREZ",
"AuthorizedOfficialFirstName": "MANUEL",
"AuthorizedOfficialMiddleName": "MIRELES",
"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "361-215-3285",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Specialist",
"LicenseNumber": "F7877",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}