Healthcare Provider Details

I. General information

NPI: 1093147860
Provider Name (Legal Business Name): SUNCARE REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8370 W HILLSBOROUGH AVE SUITE 103
TAMPA FL
33615-3898
US

IV. Provider business mailing address

8370 W HILLSBOROUGH AVE SUITE 103
TAMPA FL
33615-3898
US

V. Phone/Fax

Practice location:
  • Phone: 813-302-1733
  • Fax:
Mailing address:
  • Phone: 813-302-1733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILLIP PULLEN
Title or Position: CO-OWNER
Credential: DO
Phone: 813-302-1733