{
"Npi": {
"NPI": "1780731257",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "THOMAS NAMNOUM",
"FirstName": "LESA",
"MiddleName": "A",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13914 CONDO PLAYA BUYE",
"SecondLineMailingAddress": "APT 204",
"MailingAddressCityName": "CABO ROJO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00623",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-237-3438",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "PR RENAL HEALTH",
"SecondLinePracticeLocationAddress": "BUILDING OFFICE PARK IV, #201 STREET ROAD #2 KM 156.5",
"PracticeLocationAddressCityName": "MAYAGUEZ",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00680",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-986-5050",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/05/2007",
"LastUpdateDate": "12/04/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RN0300X",
"TaxonomyName": "Nephrology Physician",
"LicenseNumber": "11054",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}