Provider Demographics
NPI:1215471115
Name:SUNRISE MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:SUNRISE MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-785-4540
Mailing Address - Street 1:3820 TAMPA RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3609
Mailing Address - Country:US
Mailing Address - Phone:727-785-4540
Mailing Address - Fax:727-781-7900
Practice Address - Street 1:3820 TAMPA RD
Practice Address - Street 2:SUITE 202
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3609
Practice Address - Country:US
Practice Address - Phone:727-785-4540
Practice Address - Fax:727-781-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty