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General NPI Number Information
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NPI Number | 1346859451
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Entity Type | Organization
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Legal Business Name | SUNSHINE DIAGNOSTICS LABORATORY, LLC
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 1665 DR MARTIN LUTHER KING JR BLVD STE 12
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-7126
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Country | US
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Telephone | 561-267-1447
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10868
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City | RIVIERA BEACH
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State | FL
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Zip | 33419-0868
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Country | US
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Telephone | 561-267-1447
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MUHAMMAD T BHINDER
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Credential |
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Telephone | 561-267-1447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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