Provider Demographics
NPI:1275578510
Name:HAYNES MILAS STERLING PA
Entity Type:Organization
Organization Name:HAYNES MILAS STERLING PA
Other - Org Name:SUNCOAST PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRICIAN PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON-MILAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-584-6802
Mailing Address - Street 1:1395 W BAY DR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770
Mailing Address - Country:US
Mailing Address - Phone:727-584-6802
Mailing Address - Fax:727-586-6278
Practice Address - Street 1:1395 W BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770
Practice Address - Country:US
Practice Address - Phone:727-584-6802
Practice Address - Fax:727-586-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062649000Medicaid