{
"Npi": {
"NPI": "1881874857",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LEVITTOWN OPTICAL INC",
"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": "PB-4 CARIBE ST",
"SecondLineMailingAddress": "PARQUE PUNTA SALINAS",
"MailingAddressCityName": "TOA BAJA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00949",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-690-8093",
"MailingAddressFaxNumber": "787-690-8926",
"FirstLinePracticeLocationAddress": "#9 DR ALVAREZ CHANCA AVE",
"SecondLinePracticeLocationAddress": "LOCAL A 5TA SECC LEVITTOWN",
"PracticeLocationAddressCityName": "TOA BAJA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00949",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-690-8093",
"PracticeLocationAddressFaxNumber": "787-690-8926",
"EnumerationDate": "11/07/2007",
"LastUpdateDate": "11/07/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PRIETO MATTA",
"AuthorizedOfficialFirstName": "SARAHI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LICENSED OPTICIAN",
"AuthorizedOfficialTelephoneNumber": "787-662-1572",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "156FX1800X",
"TaxonomyName": "Optician",
"LicenseNumber": "621",
"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."
}
}
}
}