Healthcare Provider Details

I. General information

NPI: 1760935696
Provider Name (Legal Business Name): SUNSHINE MEDICAL SYSTEMS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2016
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 BOUTWELL RD
LAKE WORTH FL
33461-2610
US

IV. Provider business mailing address

3185 BOUTWELL RD
LAKE WORTH FL
33461-2610
US

V. Phone/Fax

Practice location:
  • Phone: 561-533-0074
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES AITKEN
Title or Position: CEO
Credential:
Phone: 561-318-4455