Healthcare Provider Details

I. General information

NPI: 1760873590
Provider Name (Legal Business Name): SUNSHINE MEDICINE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 07/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13692 W HILLSBOROUGH AVE
TAMPA FL
33635-9638
US

IV. Provider business mailing address

13692 W HILLSBOROUGH AVE
TAMPA FL
33635-9638
US

V. Phone/Fax

Practice location:
  • Phone: 813-252-2375
  • Fax: 813-324-5680
Mailing address:
  • Phone: 813-252-2375
  • Fax: 813-324-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME112438
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME112438
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME112438
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME112438
License Number StateFL

VIII. Authorized Official

Name: NAUMAN SALIM
Title or Position: PRESIDENT
Credential: MD
Phone: 317-847-3669