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General NPI Number Information
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NPI Number | 1861038143
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Entity Type | Organization
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Legal Business Name | SUNMED LLC
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Dates
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Enumeration Date | 11/21/2019
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 35095 US HIGHWAY 19 N STE 102
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City | PALM HARBOR
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State | FL
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Zip | 34684-1968
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Country | US
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Telephone | 727-674-1400
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Fax | 727-724-4483
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Provider Business Mailing Address
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Address Line | 35095 US HIGHWAY 19 N STE 102
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City | PALM HARBOR
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State | FL
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Zip | 34684-1968
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Country | US
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Telephone | 727-674-1400
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Fax | 727-724-4483
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Authorized Official
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Title or Position | OWNER
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Name | MR. PHILIP MARK HAYS
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Credential |
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Telephone | 727-674-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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