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NPI Code Detail

MEDICARE: SUNNY MEDICAL PL, LLC.

MEDICARE: SUNNY MEDICAL PL, LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/CenterFL

General Provider Information

NPI Number : 1336249606
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNNY MEDICAL PL, LLC.
Provider Business Mailing Address
First Line : 11183 S ORANGE BLOSSOM TRL
Second Line : SUITE 204D
City : ORLANDO
State : FL
Zip : 32837-9402
Country : US
Telephone Number : 407-850-0103
Fax Number : 407-850-9901
Provider Business Practice Location Address
First Line : 11183 S ORANGE BLOSSOM TRL
Second Line : SUITE 204D
City : ORLANDO
State : FL
Zip : 32837-9402
Country : US
Telephone Number : 407-850-0103
Fax Number : 407-850-9901
Authorized Official
Title or Position : MANAGER
Name : DR. EMILIA VIVES
Credential : M.D.
Telephone Number : 407-850-0103
Provider Enumeration Date : 09/25/2006
Last Update Date : 10/16/2007

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Directions to “SUNNY MEDICAL PL, LLC. ” Practice Location

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