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General NPI Number Information
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NPI Number | 1215233184
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Entity Type | Organization
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Legal Business Name | SUNSHINE SPINE AND PAIN PA
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Dates
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Enumeration Date | 02/09/2011
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 4788 HODGES BLVD STE 105
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City | JACKSONVILLE
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State | FL
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Zip | 32224-7223
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Country | US
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Telephone | 904-651-8206
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Fax | 904-900-2221
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Provider Business Mailing Address
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Address Line | PO BOX 919327
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City | ORLANDO
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State | FL
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Zip | 32891-9327
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Country | US
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Telephone | 904-651-8206
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Fax | 904-900-2221
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Authorized Official
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Title or Position | GM
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Name | SAMKA KURDIJA
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Credential |
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Telephone | 904-525-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME84002
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License Number State | FL
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