{
"Npi": {
"NPI": "1699213041",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SERVICIOS CLINICOS DEL ESTE INC",
"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": "41 URB COSTA VERDE",
"SecondLineMailingAddress": "PALMAS DEL MAR",
"MailingAddressCityName": "HUMACAO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00791-6037",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "CARR 190 KM 1.8",
"SecondLinePracticeLocationAddress": "BOCA CANGREJO",
"PracticeLocationAddressCityName": "CAROLINA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00983",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-646-7769",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/06/2017",
"LastUpdateDate": "02/06/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONZALEZ",
"AuthorizedOfficialFirstName": "ISMARY",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENTE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-646-7769",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}