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General NPI Number Information
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NPI Number | 1639759202
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Entity Type | Organization
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Legal Business Name | SUNSHINE KIDNEY CARE LLC
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 1400 N US HIGHWAY 441 STE 522
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City | THE VILLAGES
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State | FL
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Zip | 32159-8983
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Country | US
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Telephone | 352-388-5800
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Fax | 352-388-7001
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Provider Business Mailing Address
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Address Line | 13900 COUNTY ROAD 455 UNIT 107 #402
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City | CLERMONT
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State | FL
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Zip | 34711-9052
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Country | US
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Telephone | 352-388-5800
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Fax | 352-388-7001
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Authorized Official
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Title or Position | OWNER
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Name | JOHN S. HAYES
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Credential | MD
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Telephone | 352-388-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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