{
"Npi": {
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "LABORATORIO CLINICO PLAZA CAROLINA INC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 9741",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAROLINA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00988-9741",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-768-0070",
"MailingAddressFaxNumber": "787-768-0070",
"FirstLinePracticeLocationAddress": "AVE. FRAGOSO & EXPRESO LOIZA",
"SecondLinePracticeLocationAddress": "OFFICE #12 3ER NIVEL PLAZA CAROLINA MALL",
"PracticeLocationAddressCityName": "CAROLINA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00988",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-768-0070",
"PracticeLocationAddressFaxNumber": "787-768-0070",
"EnumerationDate": "04/21/2006",
"LastUpdateDate": "02/09/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PINEIRO",
"AuthorizedOfficialFirstName": "EDGARDO",
"AuthorizedOfficialMiddleName": "GENARO",
"AuthorizedOfficialTitle": "SECRETARY (OWNER)",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "SR.",
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "787-616-7253",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "871",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}