Provider Demographics
NPI:1538249859
Name:SUNSET POINT HEALTHCARE CLINIC LLC
Entity type:Organization
Organization Name:SUNSET POINT HEALTHCARE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-799-3319
Mailing Address - Street 1:2329 SUNSET POINT RD STE 204
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1438
Mailing Address - Country:US
Mailing Address - Phone:727-799-3319
Mailing Address - Fax:727-799-8859
Practice Address - Street 1:2329 SUNSET POINT RD #204
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1516
Practice Address - Country:US
Practice Address - Phone:727-799-3319
Practice Address - Fax:727-799-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT56324Medicare UPIN
FL89741AMedicare ID - Type Unspecified