| Sunshine Primary Care Llc | |
|
17921 Hunting Bow Cir Suite 101 Lutz FL 33558-5379 | |
| (813) 792-1900 | |
| Not Available |
| Full Name | Sunshine Primary Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 17921 Hunting Bow Cir, Lutz, Florida |
| Authorized Official Name and Position | Ghiath Kashlan (OWNER/PROVIDER/CEO) |
| Authorized Official Contact | 8137921900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunshine Primary Care Llc 17921 Hunting Bow Cir Suite 101 Lutz FL 33558-5379 Ph: (813) 792-1900 | Sunshine Primary Care Llc 17921 Hunting Bow Cir Suite 101 Lutz FL 33558-5379 Ph: (813) 792-1900 |
| NPI Number | 1861734824 |
|---|---|
| Provider Enumeration Date | 03/17/2013 |
| Last Update Date | 03/25/2013 |
| Medicare PECOS PAC ID | 0941440747 |
|---|---|
| Medicare Enrollment ID | O20130627000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861734824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME106343 (Florida) | Primary |
| Provider Name | Ghiath Kashlan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053393561 PECOS PAC ID: 2264492206 Enrollment ID: I20110112000069 |
| Provider Name | Cassandra R Cameron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679940373 PECOS PAC ID: 3072817709 Enrollment ID: I20160301000199 |
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