Provider Demographics
NPI:1144312661
Name:SUN MEDICAL GROUP
Entity type:Organization
Organization Name:SUN MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSVALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PINON
Authorized Official - Suffix:
Authorized Official - Credentials:AHCA
Authorized Official - Phone:305-562-1803
Mailing Address - Street 1:13550 KENDAL DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186
Mailing Address - Country:US
Mailing Address - Phone:305-562-1803
Mailing Address - Fax:305-251-7010
Practice Address - Street 1:13550 SW 88TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1514
Practice Address - Country:US
Practice Address - Phone:305-562-1803
Practice Address - Fax:305-251-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty