{
"Npi": {
"NPI": "1457599110",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PEDRO J NEVAREZ BRUNO",
"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": "PO BOX 3061",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BAYAMON",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00960-3061",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-642-6272",
"MailingAddressFaxNumber": "787-785-6097",
"FirstLinePracticeLocationAddress": "URB.CIBUCO",
"SecondLinePracticeLocationAddress": "CALLE 1 C-13",
"PracticeLocationAddressCityName": "COROZAL",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00783-1341",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-451-2727",
"PracticeLocationAddressFaxNumber": "787-785-6097",
"EnumerationDate": "02/03/2009",
"LastUpdateDate": "04/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": "05/01/2009",
"NPIReactivationDate": "05/21/2009",
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEVAREZ",
"AuthorizedOfficialFirstName": "PEDRO",
"AuthorizedOfficialMiddleName": "JAVIER",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-642-6272",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "TC-AMB575",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}