{
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"EIN": null,
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"OrgName": "CENTER FOR ADVANCED SURGERY",
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"FirstLineMailingAddress": "PARQUE DE VILLA CAPARRA",
"SecondLineMailingAddress": "#21 CALLE ZUANIA",
"MailingAddressCityName": "GUAYNABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00966",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-354-5146",
"MailingAddressFaxNumber": "787-724-0283",
"FirstLinePracticeLocationAddress": "ASHFORD MEDICAL CENTER",
"SecondLinePracticeLocationAddress": "WASHINGTON #29 SUITE 504",
"PracticeLocationAddressCityName": "SAN JUAN",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00907",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-724-0278",
"PracticeLocationAddressFaxNumber": "787-724-0283",
"EnumerationDate": "01/30/2007",
"LastUpdateDate": "09/10/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IGLESIAS",
"AuthorizedOfficialFirstName": "RAFAEL",
"AuthorizedOfficialMiddleName": "ANTONIO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "787-724-0278",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "208600000X",
"TaxonomyName": "Surgery Physician",
"LicenseNumber": "13327",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}