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General NPI Number Information
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NPI Number | 1104780709
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Entity Type | Organization
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Legal Business Name | AMERICAN SUN PRIMARY CARE LLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 4063 N GOLDENROD RD STE 3
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City | WINTER PARK
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State | FL
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Zip | 32792-8905
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Country | US
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Telephone | 203-823-5055
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Fax |
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Provider Business Mailing Address
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Address Line | 14211 PORTRUSH DR
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City | ORLANDO
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State | FL
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Zip | 32828-8243
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Country | US
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Telephone | 203-823-5055
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Fax | 203-823-5055
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. DIANA AGOSTO
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Credential | APRN
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Telephone | 203-823-5055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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