Provider Demographics
NPI:1033383500
Name:SUNCOAST U R L L C
Entity Type:Organization
Organization Name:SUNCOAST U R L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-DELIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-839-7390
Mailing Address - Street 1:18958 DALE MABRY HWY N STE 102
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-4911
Mailing Address - Country:US
Mailing Address - Phone:813-839-7390
Mailing Address - Fax:
Practice Address - Street 1:18958 DALE MABRY HWY N STE 102
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-4911
Practice Address - Country:US
Practice Address - Phone:813-839-7390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty