{
"Npi": {
"NPI": "1932386323",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LABORATORIO CLINICO JARDINES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 3278",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CAROLINA",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00984-3278",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-752-0504",
"MailingAddressFaxNumber": "787-768-5818",
"FirstLinePracticeLocationAddress": "BE5 CALLE 101",
"SecondLinePracticeLocationAddress": "JARDINES DE COUNTRY CLUB",
"PracticeLocationAddressCityName": "CAROLINA",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00983-2189",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-752-0504",
"PracticeLocationAddressFaxNumber": "787-768-5818",
"EnumerationDate": "01/28/2008",
"LastUpdateDate": "09/28/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VAZQUEZ",
"AuthorizedOfficialFirstName": "EDWIN",
"AuthorizedOfficialMiddleName": "W",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-752-0504",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": "0685",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}