{
"Npi": {
"NPI": "1558391540",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MOBILE SONIX LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 947951",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAITLAND",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "32794-7951",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "407-339-7717",
"MailingAddressFaxNumber": "321-445-5559",
"FirstLinePracticeLocationAddress": "13059 PENSHURST LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WINDERMERE",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34786-6671",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "407-339-7717",
"PracticeLocationAddressFaxNumber": "321-445-5559",
"EnumerationDate": "07/04/2006",
"LastUpdateDate": "02/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FOX",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "VICE PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "407-339-7717",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0200X",
"TaxonomyName": "Radiology Clinic/Center",
"LicenseNumber": "HCC7053",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}