Sunrise Medical Clinic | |
5778 5th Ave N Saint Petersburg FL 33710-7104 | |
(727) 388-2625 | |
(727) 828-9233 |
Full Name | Sunrise Medical Clinic |
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Speciality | Clinic/Center |
Location | 5778 5th Ave N, Saint Petersburg, Florida |
Authorized Official Name and Position | Nilamben D Shah (PRESIDENT) |
Authorized Official Contact | 7274170233 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Sunrise Medical Clinic 5778 5th Ave N Saint Petersburg FL 33710-7104 Ph: (727) 388-2625 | Sunrise Medical Clinic 5778 5th Ave N Saint Petersburg FL 33710-7104 Ph: (727) 388-2625 |
NPI Number | 1194177857 |
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Provider Enumeration Date | 07/06/2016 |
Last Update Date | 01/30/2024 |
Medicare PECOS PAC ID | 5395028864 |
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Medicare Enrollment ID | O20170208000578 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194177857 | NPI | - | NPPES |
020378900 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Nilamben Deval Shah |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1356306070 PECOS PAC ID: 4183697055 Enrollment ID: I20040818000622 |
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