Provider Demographics
NPI:1730528332
Name:SUNSHINE PHYSICIANS NETWORK LLC
Entity type:Organization
Organization Name:SUNSHINE PHYSICIANS NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTOMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-869-9112
Mailing Address - Street 1:6355 NW 36 ST SUITE 500
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166
Mailing Address - Country:US
Mailing Address - Phone:305-869-9112
Mailing Address - Fax:305-869-9416
Practice Address - Street 1:6355 NW 36TH ST STE 500
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-7027
Practice Address - Country:US
Practice Address - Phone:305-869-9112
Practice Address - Fax:305-869-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization