{
"Npi": {
"NPI": "1447634886",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FHCHS OF PUERTO RICO INC.",
"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": "17 CALLE 2",
"SecondLineMailingAddress": "STE. 520",
"MailingAddressCityName": "GUAYNABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00968-1750",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-622-9797",
"MailingAddressFaxNumber": "787-622-9888",
"FirstLinePracticeLocationAddress": "17 VALENCIA #1 5TO PISO",
"SecondLinePracticeLocationAddress": "METRO OFFICE PARK",
"PracticeLocationAddressCityName": "GUAYNABO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00968-1750",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-622-9797",
"PracticeLocationAddressFaxNumber": "787-622-9888",
"EnumerationDate": "07/15/2015",
"LastUpdateDate": "07/15/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROCO-RODRIGUEZ",
"AuthorizedOfficialFirstName": "AWILDA",
"AuthorizedOfficialMiddleName": "M.",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ESQ.",
"AuthorizedOfficialTelephoneNumber": "787-622-9797",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}