Healthcare Provider Details

I. General information

NPI: 1730844549
Provider Name (Legal Business Name): SUNRISE MEDCARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2021
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 WILSON BLVD S STE 11
NAPLES FL
34117-9386
US

IV. Provider business mailing address

80 WILSON BLVD S STE 11
NAPLES FL
34117-9386
US

V. Phone/Fax

Practice location:
  • Phone: 239-208-5990
  • Fax: 239-302-6813
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ALFREDO GONZALEZ-VERGARA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 305-409-9681