Provider Demographics
NPI:1073821674
Name:SUN COUNTRY PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:SUN COUNTRY PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-678-5246
Mailing Address - Street 1:1221 ANTILLES LN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4506
Mailing Address - Country:US
Mailing Address - Phone:352-678-5246
Mailing Address - Fax:
Practice Address - Street 1:1221 ANTILLES LN
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-4506
Practice Address - Country:US
Practice Address - Phone:352-678-5246
Practice Address - Fax:352-835-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty