{
"Npi": {
"NPI": "1780923409",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BETTY CHINEA,LLC",
"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": "COND. CASA MAGGIORE CALLE UNION # 400",
"SecondLineMailingAddress": "APT 518",
"MailingAddressCityName": "GUAYNABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00969",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-376-0106",
"MailingAddressFaxNumber": "787-854-0403",
"FirstLinePracticeLocationAddress": "CALLE UNION #400",
"SecondLinePracticeLocationAddress": "COND. CASA MAGGIORE APT 518",
"PracticeLocationAddressCityName": "GUAYNABO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00969",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-376-0106",
"PracticeLocationAddressFaxNumber": "787-854-0404",
"EnumerationDate": "02/01/2013",
"LastUpdateDate": "02/01/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CHINEA",
"AuthorizedOfficialFirstName": "BETTY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-376-0106",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "207RG0100X",
"TaxonomyName": "Gastroenterology Physician",
"LicenseNumber": "12868",
"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."
}
}
}
}