{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "YARA VARGAS MD PLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2919 S ELLSWORTH RD STE 117",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MESA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85212-2166",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "480-365-0557",
"MailingAddressFaxNumber": "480-365-0996",
"FirstLinePracticeLocationAddress": "2919 S ELLSWORTH RD STE 117",
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"PracticeLocationAddressCityName": "MESA",
"PracticeLocationAddressStateName": "AZ",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-365-0557",
"PracticeLocationAddressFaxNumber": "480-365-0996",
"EnumerationDate": "07/16/2007",
"LastUpdateDate": "07/16/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBERTS",
"AuthorizedOfficialFirstName": "REAJ",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "602-214-6154",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": "33846",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}