{
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"FirstLineMailingAddress": "PO BOX 2320",
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"MailingAddressCityName": "GUAYNABO",
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"FirstLinePracticeLocationAddress": "#11 CARAZO STREET",
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"EnumerationDate": "12/05/2005",
"LastUpdateDate": "11/13/2023",
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"NPIReactivationDate": null,
"GenderCode": "M",
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"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}