{
"Npi": {
"NPI": "1619032174",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "QUIJANO-VEGA",
"FirstName": "OMAYRA",
"MiddleName": "M.",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8 EDWIN LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALM COAST",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32164-6357",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "600 N 2ND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARRISBURG",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "17101-1092",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "434-248-7508",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/26/2006",
"LastUpdateDate": "06/13/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207RE0101X",
"TaxonomyName": "Endocrinology, Diabetes & Metabolism Physician",
"LicenseNumber": "ME109479",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "2083P0011X",
"TaxonomyName": "Undersea and Hyperbaric Medicine (Preventive Medicine) Physician",
"LicenseNumber": "ME109479",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207RE0101X",
"TaxonomyName": "Endocrinology, Diabetes & Metabolism Physician",
"LicenseNumber": "M1299",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}