Provider Demographics
NPI:1346832938
Name:SUNSHINE DERMATOLOGY PA
Entity Type:Organization
Organization Name:SUNSHINE DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:APPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-353-6377
Mailing Address - Street 1:1035 S STATE ROAD 7 STE 122
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6136
Mailing Address - Country:US
Mailing Address - Phone:561-440-2242
Mailing Address - Fax:
Practice Address - Street 1:1035 S STATE ROAD 7 STE 122
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6136
Practice Address - Country:US
Practice Address - Phone:561-440-8298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-05
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty