MEDICARE: SUNARC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	94771	OTHER	FL	BCBS FL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083776231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNARC INC

Provider Business Mailing Address
First Line	:	PO BOX 21727
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-1727
Country	:	US
Telephone Number	:	727-823-2188
Fax Number	:	727-828-0723

Provider Business Practice Location Address
First Line	:	1213 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-1313
Country	:	US
Telephone Number	:	813-234-1315
Fax Number	:	813-234-7305

Authorized Official
Title or Position	:	OWNER PROVIDER
Name	:	DR. DAKSHA PATEL
Credential	:	MD
Telephone Number	:	813-234-1315

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	05/21/2009

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Directions to “SUNARC INC ” Practice Location

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