{
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"EIN": null,
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"OrgName": "CENTRO ESPECIALIZADO DE MEDICINA, C.S.P.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "PO BOX 9350",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUMACAO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00792-9350",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "939-644-1544",
"MailingAddressFaxNumber": "787-852-1490",
"FirstLinePracticeLocationAddress": "104 CALLE MUNOZ MARIN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUMACAO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00791-3481",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-285-0116",
"PracticeLocationAddressFaxNumber": "787-852-1490",
"EnumerationDate": "09/14/2012",
"LastUpdateDate": "10/29/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAZQUEZ TORRES",
"AuthorizedOfficialFirstName": "YINARIS",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "939-644-1544",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}