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General NPI Number Information
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NPI Number | 1639490246
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Entity Type | Organization
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Legal Business Name | SUMNER PEDIATRICS, PLLC
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 625 E MAIN ST SUITE #3
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2602
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Country | US
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Telephone | 615-822-8388
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Fax | 615-822-8336
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Provider Business Mailing Address
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Address Line | 625 E MAIN ST STE 4
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2602
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Country | US
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Telephone | 615-822-8388
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Fax | 615-822-8336
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Authorized Official
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Title or Position | MD/OWNER
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Name | MARIA CORAZON VILLAREAL BENITEZ-BRAUER
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Credential | MD
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Telephone | 615-822-8388
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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 | 31145
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License Number State | TN
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