Provider Demographics
NPI:1821412578
Name:SUNSET NEUROLOGICAL GROUP LLC
Entity Type:Organization
Organization Name:SUNSET NEUROLOGICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALFARO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:786-753-7467
Mailing Address - Street 1:7374 SW 93RD AVE
Mailing Address - Street 2:201A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-5201
Mailing Address - Country:US
Mailing Address - Phone:305-270-7774
Mailing Address - Fax:305-270-7775
Practice Address - Street 1:7374 SW 93RD AVE
Practice Address - Street 2:201A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5201
Practice Address - Country:US
Practice Address - Phone:305-270-7774
Practice Address - Fax:305-270-7775
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSET NEUROLOGICAL GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-14
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002760700Medicaid
FL053698900Medicaid