{
"Npi": {
"NPI": "1437754975",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "PERES",
"FirstName": "LOREN",
"MiddleName": "ELIZABETH",
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "235 COCONUT PALM PKWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PONTE VEDRA",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32081-6076",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "904-612-6466",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2001 KINGSLEY AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ORANGE PARK",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "32073-5156",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "904-639-8500",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/02/2020",
"LastUpdateDate": "02/01/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "APRN11011082",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}