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NPI 1285915603

NPI 1285915603 : SUNSHINE PEDIATRICS OF OCALA PA : OCALA, FL

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General NPI Number Information
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    NPI Number           |    1285915603
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    Entity Type          |    Organization 
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    Legal Business Name  |    SUNSHINE PEDIATRICS OF OCALA PA 
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Dates
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    Enumeration Date     |    08/30/2011
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    Last Update Date     |    08/02/2018
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Provider Practice Location Address
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    Address Line         |    1900 SW 20TH PL 
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    City                 |    OCALA
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    State                |    FL
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    Zip                  |    34471
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    Country              |    US
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    Telephone            |    352-840-5437
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    Fax                  |    352-237-1094
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Provider Business Mailing Address
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    Address Line         |    1900 SW 20TH PL 
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    City                 |    OCALA
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    State                |    FL
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    Zip                  |    34471-7870
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    Country              |    US
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    Telephone            |    352-840-5437
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    Fax                  |    352-237-1094
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    MR. MADHUKAR  SHRINATH 
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    Credential           |    M.D.
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    Telephone            |    352-840-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208000000X
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    Taxonomy Name        |    Pediatrics Physician
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    License Number       |    ME76333
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    261QR1300X
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    Taxonomy Name        |    Rural Health Clinic/Center
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    License Number       |    
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    License Number State |    
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