{
"Npi": {
"NPI": "1588857833",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PLAZA NUCLEAR IMAGING",
"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": "ESMERALDA AVE 53",
"SecondLineMailingAddress": "CORREO ESMERALDA PMB 114",
"MailingAddressCityName": "GUAYNABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00969",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": "787-282-0472",
"FirstLinePracticeLocationAddress": "525 AVE FD ROOSEVELT",
"SecondLinePracticeLocationAddress": "LA TORRE DE PLAZA SUITE 401",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00918-8001",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-754-0715",
"PracticeLocationAddressFaxNumber": "787-282-0472",
"EnumerationDate": "08/21/2007",
"LastUpdateDate": "08/21/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SILVA",
"AuthorizedOfficialFirstName": "FRIEDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "787-754-0715",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "PR-2001-23",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}