{
"Npi": {
"NPI": "1841475944",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "AVILES",
"FirstName": "ROSARIO",
"MiddleName": "MEDINA",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "AVILES",
"OtherFirstName": "ROSIE",
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "D.M.D.",
"OtherLastNameTypeCode": "2",
"FirstLineMailingAddress": "870 SW MARTIN DOWNS BLVD",
"SecondLineMailingAddress": "SUITE 2",
"MailingAddressCityName": "PALM CITY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "34990-2855",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "772-287-8181",
"MailingAddressFaxNumber": "772-287-3797",
"FirstLinePracticeLocationAddress": "870 SW MARTIN DOWNS BLVD",
"SecondLinePracticeLocationAddress": "SUITE 2",
"PracticeLocationAddressCityName": "PALM CITY",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34990-2855",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "772-287-8181",
"PracticeLocationAddressFaxNumber": "772-287-3797",
"EnumerationDate": "01/08/2008",
"LastUpdateDate": "05/27/2015",
"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": "1223X0400X",
"TaxonomyName": "Orthodontics and Dentofacial Orthopedics Dentistry",
"LicenseNumber": "DN 12751",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}