{
"Npi": {
"NPI": "1386072809",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "THE PROGRESSIVE ORTHOPAEDIC COMPANY, LLC",
"ParentOrgTIN": null,
"OrgName": "T-POC PR, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "239 AVE ARTERIAL HOSTOS",
"SecondLineMailingAddress": "CAPTIAL CENTER BLDG, SUITE 1002",
"MailingAddressCityName": "SAN JUAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00918-1474",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-379-6086",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "239 AVE ARTERIAL HOSTOS",
"SecondLinePracticeLocationAddress": "CAPTIAL CENTER BLDG, SUITE 1002",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00918-1474",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-379-6086",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/18/2013",
"LastUpdateDate": "10/18/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRIS",
"AuthorizedOfficialFirstName": "THOMAS",
"AuthorizedOfficialMiddleName": "BRADLEY",
"AuthorizedOfficialTitle": "MANAGING DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "304-777-4789",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "335E00000X",
"TaxonomyName": "Prosthetic/Orthotic Supplier",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}