Provider Demographics
NPI:1114585643
Name:SUNSOUTH HEALTH CENTERS SOUTH FLORIDA, LLC
Entity Type:Organization
Organization Name:SUNSOUTH HEALTH CENTERS SOUTH FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-558-1872
Mailing Address - Street 1:14255 SW 42ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6408
Mailing Address - Country:US
Mailing Address - Phone:305-306-3400
Mailing Address - Fax:
Practice Address - Street 1:1901 NW 17TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1513
Practice Address - Country:US
Practice Address - Phone:305-925-0009
Practice Address - Fax:305-697-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty