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General NPI Number Information
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NPI Number | 1770653107
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Entity Type | Organization
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Legal Business Name | SUNSHINE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 5937 BENEVA RD
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City | SARASOTA
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State | FL
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Zip | 34238-2504
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Country | US
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Telephone | 941-918-2011
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Fax | 941-918-2046
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Provider Business Mailing Address
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Address Line | 5937 BENEVA RD
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City | SARASOTA
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State | FL
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Zip | 34238-2504
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Country | US
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Telephone | 941-918-2011
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Fax | 941-918-2046
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SOORDAL O PRAKASH
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Credential | MD
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Telephone | 941-918-2011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME76860
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License Number State | FL
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