Provider Demographics
NPI:1235731522
Name:SUN MD PLLC
Entity Type:Organization
Organization Name:SUN MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAKSHMI
Authorized Official - Middle Name:NARAYANA
Authorized Official - Last Name:PADALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-436-4428
Mailing Address - Street 1:2063 N LECANTO HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461-9675
Mailing Address - Country:US
Mailing Address - Phone:352-436-4428
Mailing Address - Fax:352-228-4903
Practice Address - Street 1:2063 N LECANTO HWY
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-9675
Practice Address - Country:US
Practice Address - Phone:352-436-4428
Practice Address - Fax:352-228-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty