{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMPCARE DE PUERTO RICO",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "METRO OFFICE PARK",
"SecondLineMailingAddress": "PARKSIDE PLAZA 14 CALLE 12 SUITE 405",
"MailingAddressCityName": "GUAYNABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00968-1704",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-522-4400",
"MailingAddressFaxNumber": "787-522-4401",
"FirstLinePracticeLocationAddress": "METRO OFFICE PARK",
"SecondLinePracticeLocationAddress": "PARKSIDE PLAZA 14 CALLE 12 SUITE 405",
"PracticeLocationAddressCityName": "GUAYNABO",
"PracticeLocationAddressStateName": "PR",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-522-4400",
"PracticeLocationAddressFaxNumber": "787-522-4401",
"EnumerationDate": "02/23/2011",
"LastUpdateDate": "02/23/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RODRIGUEZ",
"AuthorizedOfficialFirstName": "JAVIER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "QUALITY DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS",
"AuthorizedOfficialTelephoneNumber": "787-522-4400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}