Provider Demographics
NPI:1275026338
Name:SUNNY MEDICAL MIAMI, LLC
Entity Type:Organization
Organization Name:SUNNY MEDICAL MIAMI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-306-0000
Mailing Address - Street 1:17070 COLLINS AVE STE T-257
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3635
Mailing Address - Country:US
Mailing Address - Phone:305-306-0000
Mailing Address - Fax:305-306-1111
Practice Address - Street 1:17070 COLLINS AVE STE T-257
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160
Practice Address - Country:US
Practice Address - Phone:305-306-0000
Practice Address - Fax:305-306-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty