{
"Npi": {
"NPI": "1649601865",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALPES ADVANCED LOGISTIC PSYCHOLOGICAL EDUCATIONAL SERVICES",
"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": "219 CALLE THEBE",
"SecondLineMailingAddress": "URB PASEO DEL SOL",
"MailingAddressCityName": "DORADO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00646-4668",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-403-5644",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "CARR #2 KM 41.3",
"SecondLinePracticeLocationAddress": "BO ALGARROBO",
"PracticeLocationAddressCityName": "VEGA BAJA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00693",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-403-5644",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/13/2013",
"LastUpdateDate": "01/22/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OTERO",
"AuthorizedOfficialFirstName": "MARIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "787-403-5644",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "103TA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Psychologist",
"LicenseNumber": "4161",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TH0100X",
"TaxonomyName": "Health Service Psychologist",
"LicenseNumber": "4161",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "235Z00000X",
"TaxonomyName": "Speech-Language Pathologist",
"LicenseNumber": "953",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "13642",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "103TC0700X",
"TaxonomyName": "Clinical Psychologist",
"LicenseNumber": "4161",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}