Provider Demographics
NPI:1033280904
Name:CITY OF SUNRISE
Entity type:Organization
Organization Name:CITY OF SUNRISE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-746-3400
Mailing Address - Street 1:PO BOX 947591
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30394-7591
Mailing Address - Country:US
Mailing Address - Phone:954-746-3400
Mailing Address - Fax:954-746-3455
Practice Address - Street 1:10770 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6816
Practice Address - Country:US
Practice Address - Phone:954-746-3400
Practice Address - Fax:954-746-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26493416L0300X, 341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL088094900Medicaid
FLA0408Medicare ID - Type UnspecifiedSUNRISE FIRE RESCUE