Healthcare Provider Details

I. General information

NPI: 1942660816
Provider Name (Legal Business Name): SUNMED HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 NW 168TH ST SUITE 301
NORTH MIAMI BEACH FL
33169-6045
US

IV. Provider business mailing address

150 NW 168TH ST SUITE 301
NORTH MIAMI BEACH FL
33169-6045
US

V. Phone/Fax

Practice location:
  • Phone: 305-944-1122
  • Fax: 305-944-1133
Mailing address:
  • Phone: 305-944-1122
  • Fax: 305-944-1133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ALEXANDER TIRADO
Title or Position: PRESIDENT
Credential: P.A.-C
Phone: 305-944-1122