{
"Npi": {
"NPI": "1609910793",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMACIA LA FE 4",
"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": "CARR 371 KM 17 BO ALMACIGO BAJO",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "YAUCO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00698",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-267-2007",
"MailingAddressFaxNumber": "787-267-2047",
"FirstLinePracticeLocationAddress": "108 CALLE VICTORIA",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PONCE",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00730-3767",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-842-3201",
"PracticeLocationAddressFaxNumber": "787-848-0858",
"EnumerationDate": "02/20/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODRIGUEZ",
"AuthorizedOfficialFirstName": "LOURDES",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "PHARMACIST",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-267-2007",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "333600000X",
"TaxonomyName": "Pharmacy",
"LicenseNumber": "07F2044",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}