{
"Npi": {
"NPI": "1558776732",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "A.S.L. CSP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"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": "790 CALLE ARBOLEDA",
"SecondLineMailingAddress": "HACIENDAS CONSTANCIA",
"MailingAddressCityName": "HORMIGUEROS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00660-9618",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-560-3209",
"MailingAddressFaxNumber": "787-849-2548",
"FirstLinePracticeLocationAddress": "510 CARR #2",
"SecondLinePracticeLocationAddress": "SUITE 103 PLAZA CONSTANCIA",
"PracticeLocationAddressCityName": "HORMIGUEROS",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00660-9745",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-843-2548",
"PracticeLocationAddressFaxNumber": "787-849-2548",
"EnumerationDate": "06/25/2014",
"LastUpdateDate": "06/25/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONZALEZ",
"AuthorizedOfficialFirstName": "GERMAN",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "787-849-2548",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "11976",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}