| Sunstate Managed Care Llc | |
|
3820 Tampa Road Suite 202 Palm Harbor FL 34684-3609 | |
| (727) 785-4540 | |
| (727) 781-7900 |
| Full Name | Sunstate Managed Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3820 Tampa Road, Palm Harbor, Florida |
| Authorized Official Name and Position | Cheryl Payne (CFO) |
| Authorized Official Contact | 7277854540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunstate Managed Care Llc Po Box 566 Palm Harbor FL 34682-0566 Ph: (727) 785-4540 | Sunstate Managed Care Llc 3820 Tampa Road Suite 202 Palm Harbor FL 34684-3609 Ph: (727) 785-4540 |
| NPI Number | 1164875290 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/13/2016 |
| Medicare PECOS PAC ID | 2264853944 |
|---|---|
| Medicare Enrollment ID | O20200604002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164875290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Francisco J Rey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013062835 PECOS PAC ID: 0749276970 Enrollment ID: I20040426001732 |
| Provider Name | George P Macris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336445055 PECOS PAC ID: 8820013840 Enrollment ID: I20190830001942 |
| Provider Name | Kiran Naidoo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1659935369 PECOS PAC ID: 2466783162 Enrollment ID: I20191010002004 |
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