Provider Demographics
NPI:1366641698
Name:SUNSET POINT MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:SUNSET POINT MEDICAL ASSOCIATES INC
Other - Org Name:TARPON SPRINGS MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-785-4540
Mailing Address - Street 1:3820 TAMPA RD STE 202
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3609
Mailing Address - Country:US
Mailing Address - Phone:727-785-4540
Mailing Address - Fax:727-773-9716
Practice Address - Street 1:3820 TAMPA RD STE 202
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3609
Practice Address - Country:US
Practice Address - Phone:727-785-4540
Practice Address - Fax:877-508-7487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47065207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL33310OtherBCBS GROUP
FL046784700Medicaid
FL5509587OtherGHI
FLK-1130Medicare PIN