{
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"FirstLineMailingAddress": "HC #4 BOX 6737",
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"MailingAddressStateName": "PUERTO RICO",
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"FirstLinePracticeLocationAddress": "CALLE ULISES MARTINEZ NORTE 50",
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"EnumerationDate": "07/23/2015",
"LastUpdateDate": "07/23/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RIVERA",
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}
},
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}
}