{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAKE CITY DIAGNOSTIC IMAGING, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"FirstLineMailingAddress": "23 MAIN ST",
"SecondLineMailingAddress": "SUITE 103",
"MailingAddressCityName": "HILTON HEAD",
"MailingAddressStateName": "SC",
"MailingAddressPostalCode": "29926-6606",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "843-342-2400",
"MailingAddressFaxNumber": "843-342-5898",
"FirstLinePracticeLocationAddress": "148 SAULS ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE CITY",
"PracticeLocationAddressStateName": "SC",
"PracticeLocationAddressPostalCode": "29560-2631",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "843-374-0450",
"PracticeLocationAddressFaxNumber": "843-374-0451",
"EnumerationDate": "07/23/2010",
"LastUpdateDate": "09/02/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAGLAYAN",
"AuthorizedOfficialFirstName": "MURAT",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "843-342-2400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}