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General NPI Number Information
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NPI Number | 1811396161
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Entity Type | Organization
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Legal Business Name | NEW LIFE SURGICAL ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 4253 SALISBURY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216
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Country | US
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Telephone | 904-399-4004
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Fax | 904-399-3489
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Provider Business Mailing Address
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Address Line | 4253 SALISBURY RD
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City | JACKSONVILLE
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State | FL
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Zip | 32216
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Country | US
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Telephone | 904-399-4004
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Fax | 904-399-3489
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | SUNIL K SHARMA
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Credential | M.D.
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Telephone | 904-399-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME 104571
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License Number State | FL
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