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NPI Code Detail

MEDICARE: SUNRISE LIVING

MEDICARE: SUNRISE LIVING
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
1251B00000XCase Management Agency300290517FL

General Provider Information

NPI Number : 1255876157
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNRISE LIVING
Provider Business Mailing Address
First Line : 1419 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-5249
Country : US
Telephone Number : 904-924-4825
Fax Number :
Provider Business Practice Location Address
First Line : 1419 UNIVERSITY BLVD N
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-5249
Country : US
Telephone Number : 904-924-4825
Fax Number :
Authorized Official
Title or Position : CASE MANAGER
Name : MS. SHERRILL MARSHALL
Credential :
Telephone Number : 904-716-0712
Provider Enumeration Date : 12/31/2016
Last Update Date : 12/31/2016

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1255878534 — MEDGINA ETIENNE
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Directions to “SUNRISE LIVING ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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