Provider Demographics
NPI:1538563754
Name:SUNFLOWER CONCIERGE MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:SUNFLOWER CONCIERGE MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIYANKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:321-279-5579
Mailing Address - Street 1:948 S WICKHAM RD
Mailing Address - Street 2:STE 101
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-1647
Mailing Address - Country:US
Mailing Address - Phone:321-956-7370
Mailing Address - Fax:
Practice Address - Street 1:948 S WICKHAM RD
Practice Address - Street 2:STE 101
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1647
Practice Address - Country:US
Practice Address - Phone:321-956-7370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-17
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty