Healthcare Provider Details

I. General information

NPI: 1316681034
Provider Name (Legal Business Name): SUNSHINE SPINE AND PAIN SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 BEE RIDGE RD BUILDING C UNIT A
SARASOTA FL
34233
US

IV. Provider business mailing address

3920 BEE RIDGE RD BUILDING C UNIT A
SARASOTA FL
34233
US

V. Phone/Fax

Practice location:
  • Phone: 941-867-7463
  • Fax: 941-870-3839
Mailing address:
  • Phone: 941-867-7463
  • Fax: 941-870-3839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER FERNANDEZ
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 336-406-5795