{
"Npi": {
"NPI": "1659813418",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "FERNANDEZ",
"FirstName": "ROSA",
"MiddleName": "INES",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "CRNA, MBA",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CORREA VELEZ",
"OtherFirstName": "ROSA",
"OtherMiddleName": "INES",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "CRNA",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "7540 LANCASTER LOOP",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WESLEY CHAPEL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33545-9145",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3120 CALLE PORTUGUES",
"SecondLinePracticeLocationAddress": "VILLA DOS RIOS",
"PracticeLocationAddressCityName": "PONCE",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00730-4541",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-341-9680",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/10/2016",
"LastUpdateDate": "03/26/2024",
"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": "367500000X",
"TaxonomyName": "Certified Registered Nurse Anesthetist",
"LicenseNumber": "9466078",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}