{
"Npi": {
"NPI": "1427541606",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LCDA.MORAIMA GARCIA VERGARA",
"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": "104 CALLE LUIS MUNOZ RIVERA",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YABUCOA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00767-3103",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "50 CALLE VICTORIA STE 17 LEGACY MEDICAL CENTER",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUMACAO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00791-3337",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-318-2041",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/12/2018",
"LastUpdateDate": "05/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GARCIA",
"AuthorizedOfficialFirstName": "MORAIMA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "NUTRITIONIST/DIETITIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-318-2041",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "133V00000X",
"TaxonomyName": "Registered Dietitian",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}