{
"Npi": {
"NPI": "1366884090",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTO DE IMAGEN-RADIOLOGIA DIGITAL OMIAN INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "159 PASEO TORRE ALTA",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BARRANQUITAS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00794-9444",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-381-4665",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "61 CALLE GEORGETTI",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NARANJITO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00719-3027",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-381-4665",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/23/2013",
"LastUpdateDate": "02/18/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HERNANDEZ",
"AuthorizedOfficialFirstName": "OMY",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENTE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-381-4665",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}