Provider Demographics
NPI:1093863193
Name:SUNSET RADIOLOGY INC
Entity Type:Organization
Organization Name:SUNSET RADIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAVENTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-273-6602
Mailing Address - Street 1:7000 SW 97TH AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-273-6602
Mailing Address - Fax:305-273-6603
Practice Address - Street 1:7000 SW 97TH AVE STE 117
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1474
Practice Address - Country:US
Practice Address - Phone:305-273-6602
Practice Address - Fax:305-273-6603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL585023-6261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6591Medicare PIN
FLY47037Medicare UPIN