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General NPI Number Information
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NPI Number | 1407149446
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Entity Type | Organization
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Legal Business Name | SUNRISE MEDICAL HEALTH GROUP
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 5555 GOLDEN GATE PKWY STE 137
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City | NAPLES
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State | FL
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Zip | 34116-7575
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Country | US
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Telephone | 239-300-0240
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Fax | 239-300-0241
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Provider Business Mailing Address
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Address Line | 5555 GOLDEN GATE PKWY STE 137
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City | NAPLES
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State | FL
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Zip | 34116-7575
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Country | US
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Telephone | 239-300-0240
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Fax | 239-300-0241
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ANTONIO E TERRELONGE
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Credential | M.D
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Telephone | 239-300-0240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | HCC9064
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License Number State | FL
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