{
"Npi": {
"NPI": "1982755872",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FARMACIA LASALLE NIEVES 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 976",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "QUEBRADILLAS",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00678-0976",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-895-1001",
"MailingAddressFaxNumber": "787-895-1882",
"FirstLinePracticeLocationAddress": "CARR 113 KM 11.6",
"SecondLinePracticeLocationAddress": "CACAO WARD",
"PracticeLocationAddressCityName": "QUEBRADILLAS",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00678-2621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-895-1001",
"PracticeLocationAddressFaxNumber": "787-895-1882",
"EnumerationDate": "01/16/2007",
"LastUpdateDate": "03/07/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NIEVES-CURBELO",
"AuthorizedOfficialFirstName": "DIANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH",
"AuthorizedOfficialTelephoneNumber": "787-895-1001",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3336C0003X",
"TaxonomyName": "Community/Retail Pharmacy",
"LicenseNumber": "07-F-1207",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}