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General NPI Number Information
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NPI Number | 1538452701
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Entity Type | Organization
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Legal Business Name | SUNSHINE INJURY HEALING CENTER
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Dates
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Enumeration Date | 05/22/2011
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Last Update Date | 05/22/2011
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Provider Practice Location Address
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Address Line | 13220 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-1107
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Country | US
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Telephone | 813-988-4644
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Fax |
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Provider Business Mailing Address
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Address Line | 13220 N 56TH ST
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-1107
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Country | US
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Telephone | 813-988-4644
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. REINHARD E ROTT
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Credential | MD, FACS
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Telephone | 813-988-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | FL
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