{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "RV MEDICAL PSC",
"LastName": null,
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"FirstLineMailingAddress": "HC 4 BOX 19741",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GURABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00778-8840",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-850-6654",
"MailingAddressFaxNumber": "787-719-4677",
"FirstLinePracticeLocationAddress": "CARR 3 KM 85.5",
"SecondLinePracticeLocationAddress": "BO CANDELERO ARRIBA OFICINA 2 EDIFICIO PLAZA DEL MAR",
"PracticeLocationAddressCityName": "HUMACAO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-850-6654",
"PracticeLocationAddressFaxNumber": "787-719-4677",
"EnumerationDate": "01/28/2016",
"LastUpdateDate": "01/28/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VELEZ DE JESUS",
"AuthorizedOfficialFirstName": "ROBERTO",
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"AuthorizedOfficialTitle": "DOCTOR",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "787-850-6654",
"Taxonomies": {
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"TaxonomyName": "Health Service Clinic/Center",
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"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}