{
"Npi": {
"NPI": "1386686921",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GONASA CORP",
"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": "HC 83 BOX 6204",
"SecondLineMailingAddress": "SECTOR MONTE REY",
"MailingAddressCityName": "VEGA ALTA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00692-9706",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-883-2913",
"MailingAddressFaxNumber": "787-270-2593",
"FirstLinePracticeLocationAddress": "CARR 694 KM 1.2",
"SecondLinePracticeLocationAddress": "SECTOR MONTE REY BO ESPINOSA",
"PracticeLocationAddressCityName": "VEGA ALTA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00692",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-270-1816",
"PracticeLocationAddressFaxNumber": "787-270-2593",
"EnumerationDate": "06/11/2006",
"LastUpdateDate": "10/06/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RUIZ RIVERA",
"AuthorizedOfficialFirstName": "DAMARIS",
"AuthorizedOfficialMiddleName": "MARILIA",
"AuthorizedOfficialTitle": "PIC/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.PH.",
"AuthorizedOfficialTelephoneNumber": "787-883-2913",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "17F2233",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}