| Sunstate Healthcare Llc | |
|
12120 Cortez Blvd Brooksville FL 34613-5514 | |
| (352) 559-8849 | |
| (352) 559-8872 |
| Full Name | Sunstate Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12120 Cortez Blvd, Brooksville, Florida |
| Authorized Official Name and Position | Guesly J Delva (PRESIDENT) |
| Authorized Official Contact | 3525598849 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunstate Healthcare Llc 12120 Cortez Blvd Brooksville FL 34613-5514 Ph: (352) 559-8849 | Sunstate Healthcare Llc 12120 Cortez Blvd Brooksville FL 34613-5514 Ph: (352) 559-8849 |
| NPI Number | 1558718999 |
|---|---|
| Provider Enumeration Date | 05/16/2016 |
| Last Update Date | 09/21/2016 |
| Medicare PECOS PAC ID | 7113210444 |
|---|---|
| Medicare Enrollment ID | O20160725002389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558718999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME120716 (Florida) | Primary |
| Provider Name | Guesly Jerome Delva |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750562724 PECOS PAC ID: 1557523602 Enrollment ID: I20141118000670 |
| Provider Name | Cathlen S Delva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205275013 PECOS PAC ID: 7517228380 Enrollment ID: I20180220000138 |
| Provider Name | Barbara Jean Giles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821584327 PECOS PAC ID: 4688910698 Enrollment ID: I20190111002882 |
| Provider Name | Angela Hutcheson-smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639750433 PECOS PAC ID: 6507258894 Enrollment ID: I20220118002615 |
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