Sun Md Pllc | |
2063 N Lecanto Hwy Lecanto FL 34461-9675 | |
(352) 436-4428 | |
(352) 228-4903 |
Full Name | Sun Md Pllc |
---|---|
Speciality | Family Medicine |
Location | 2063 N Lecanto Hwy, Lecanto, Florida |
Authorized Official Name and Position | Lakshmi Narayana Padala (PRESIDENT) |
Authorized Official Contact | 3524364428 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Sun Md Pllc 2063 N Lecanto Hwy Ste 1 Lecanto FL 34461-9675 Ph: (352) 436-4428 | Sun Md Pllc 2063 N Lecanto Hwy Lecanto FL 34461-9675 Ph: (352) 436-4428 |
NPI Number | 1235731522 |
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Provider Enumeration Date | 11/11/2020 |
Last Update Date | 10/22/2021 |
Medicare PECOS PAC ID | 3173934346 |
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Medicare Enrollment ID | O20201118002151 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235731522 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Lakshmi Narayana Padala |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1053379735 PECOS PAC ID: 5698787869 Enrollment ID: I20120806000813 |
Provider Name | Theresa Montgomery Tyrie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649753468 PECOS PAC ID: 1557590411 Enrollment ID: I20181114003662 |
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