{
"Npi": {
"NPI": "1881850428",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "ROMAN NIEVES",
"FirstName": "LEYDA",
"MiddleName": "MELENY",
"NamePrefix": "DR.",
"NameSuffix": null,
"Credential": "MD",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "#33 CALLE FANTASIA",
"SecondLineMailingAddress": "CUIDAD JARDIN URB LOS SUENOS",
"MailingAddressCityName": "GURABO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00778",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-458-2419",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "URBANIZACION EL RECREO",
"SecondLinePracticeLocationAddress": "CALLE RAFAEL ROSARIO ARROYO #46",
"PracticeLocationAddressCityName": "HUMACAO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00791",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-852-1355",
"PracticeLocationAddressFaxNumber": "787-266-9782",
"EnumerationDate": "08/04/2008",
"LastUpdateDate": "04/07/2020",
"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": "208000000X",
"TaxonomyName": "Pediatrics Physician",
"LicenseNumber": "18286",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}