{
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"NamePrefix": null,
"NameSuffix": null,
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"FirstLineMailingAddress": "URB DEL CARMEN CALLE 9",
"SecondLineMailingAddress": "H 68",
"MailingAddressCityName": "CAMUY",
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"MailingAddressPostalCode": "00627",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-262-7300",
"MailingAddressFaxNumber": "787-262-7200",
"FirstLinePracticeLocationAddress": "CARR 486 KM 2.0",
"SecondLinePracticeLocationAddress": "BO ZANJAS",
"PracticeLocationAddressCityName": "CAMUY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-262-7300",
"PracticeLocationAddressFaxNumber": "787-262-7200",
"EnumerationDate": "04/22/2010",
"LastUpdateDate": "09/12/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBLES",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-356-0338",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "333600000X",
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"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3336C0003X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}