{
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"IsOrgSubpart": "N",
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"OrgName": "CENTROS DE PREVENCION TRATAMIENTO DE ENFERMEDADES TRANSMISIBLES",
"LastName": null,
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"FirstLineMailingAddress": "CLINICA INMUNOLOGICA DE HUMACAO",
"SecondLineMailingAddress": "BOX 8548",
"MailingAddressCityName": "CAGUAS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00726-8548",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-704-7066",
"MailingAddressFaxNumber": "787-746-2896",
"FirstLinePracticeLocationAddress": "100 CALLE FONT MARTELO W",
"SecondLinePracticeLocationAddress": "CLINICA INMUNOLOGICA DE HUMACAO LOCAL 13Y14",
"PracticeLocationAddressCityName": "HUMACAO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00791-3923",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-704-7066",
"PracticeLocationAddressFaxNumber": "787-746-2896",
"EnumerationDate": "04/12/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODRIGUEZ",
"AuthorizedOfficialFirstName": "CARMEN",
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"AuthorizedOfficialTitle": "DIRETOR EJECUTIVA",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MPA",
"AuthorizedOfficialTelephoneNumber": "787-771-2100",
"Taxonomies": {
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}