=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326101171
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WILLIAM SUNSHINE MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2006
-----------------------------------------------------
Last Update Date | 01/20/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1905 CLINT MOORE RD STE 308
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33496-2658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-862-0401
-----------------------------------------------------
Fax | 561-862-0402
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1905 CLINT MOORE RD STE 308
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33496-2658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-862-0401
-----------------------------------------------------
Fax | 561-862-0402
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. WILLIAM A SUNSHINE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 561-862-0401
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | 167422769
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------