{
"Npi": {
"NPI": "1629748520",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTRO CARDIOVASCULAR CHAPALITA",
"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": "1441 WOODMONT LN NW # 1398",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30318-2866",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "AV NINO OBRERO 1666",
"SecondLinePracticeLocationAddress": "COL CHAPALITA",
"PracticeLocationAddressCityName": "ZAPOPAN",
"PracticeLocationAddressStateName": "JALISCO",
"PracticeLocationAddressPostalCode": "45040",
"PracticeLocationAddressCountryCode": "MX",
"PracticeLocationAddressTelephoneNumber": "333-878-1400",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/14/2021",
"LastUpdateDate": "02/28/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EZQUERRA",
"AuthorizedOfficialFirstName": "JAVIER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MGR",
"AuthorizedOfficialTelephoneNumber": "801-896-1181",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "282N00000X",
"TaxonomyName": "General Acute Care Hospital",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}