{
"Npi": {
"NPI": "1689161374",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "COLON DE LEON",
"FirstName": "ENRIQUE",
"MiddleName": "L.",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PSYCHOLOGY DOCTOR",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 11752",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN JUAN",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00910-2852",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-639-3231",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "607 CALLE JULIO GONZALEZ",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00924-3717",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-639-3231",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/18/2018",
"LastUpdateDate": "04/18/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "103TC1900X",
"TaxonomyName": "Counseling Psychologist",
"LicenseNumber": "2954",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}