{
"Npi": {
"NPI": "1679707806",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ADVANCED BREAST CLINICS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 633",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DORADO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00646-0633",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-784-5706",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1000 AVE DOS PALMAS",
"SecondLinePracticeLocationAddress": "LEVITTOWN",
"PracticeLocationAddressCityName": "TOA BAJA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00949-4101",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-784-5706",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/01/2009",
"LastUpdateDate": "05/01/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SANTIAGO",
"AuthorizedOfficialFirstName": "CARLOS",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD, FACS",
"AuthorizedOfficialTelephoneNumber": "787-318-8930",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0206X",
"TaxonomyName": "Mammography Clinic/Center",
"LicenseNumber": "13446",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}