{
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"OrgName": "INAYA PSYCHIATRIC MEDICAL GROUP",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "PO BOX 251",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAROLINA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00986-0251",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-850-4515",
"MailingAddressFaxNumber": "787-852-6202",
"FirstLinePracticeLocationAddress": "VIA CUMBRES STREET URB LA VISTA",
"SecondLinePracticeLocationAddress": "G 11",
"PracticeLocationAddressCityName": "SAN JUAN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-850-4515",
"PracticeLocationAddressFaxNumber": "787-852-6202",
"EnumerationDate": "11/30/2010",
"LastUpdateDate": "11/30/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOPEZ RAMOS",
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"AuthorizedOfficialCredential": "MA",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": "6613",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}