{
"Npi": {
"NPI": "1962704213",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PAIN RELIEF CENTER USA CORP",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8100 SW 81ST DR",
"SecondLineMailingAddress": "290",
"MailingAddressCityName": "MIAMI",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33143-6603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-596-6644",
"MailingAddressFaxNumber": "305-596-6646",
"FirstLinePracticeLocationAddress": "8100 SW 81ST DR",
"SecondLinePracticeLocationAddress": "290",
"PracticeLocationAddressCityName": "MIAMI",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33143-6603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-596-6644",
"PracticeLocationAddressFaxNumber": "305-596-6646",
"EnumerationDate": "11/18/2010",
"LastUpdateDate": "11/18/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MATOS",
"AuthorizedOfficialFirstName": "RAMONA",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "DIRECTOR/PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "305-596-6644",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "HCC8541",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}