{
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"MailingAddressTelephoneNumber": "956-544-0237",
"MailingAddressFaxNumber": "956-544-0239",
"FirstLinePracticeLocationAddress": "5460 PAREDES LINE RD STE 199",
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"PracticeLocationAddressCityName": "BROWNSVILLE",
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"EnumerationDate": "08/29/2015",
"LastUpdateDate": "07/18/2022",
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BENITEZ",
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{
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{
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{
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}
]
},
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}
}