Provider Demographics
NPI:1831651967
Name:SUGAR 10 LLC
Entity Type:Organization
Organization Name:SUGAR 10 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HIEP
Authorized Official - Middle Name:Q
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-529-4257
Mailing Address - Street 1:541 S ORLANDO AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-5669
Mailing Address - Country:US
Mailing Address - Phone:407-529-4257
Mailing Address - Fax:
Practice Address - Street 1:541 S ORLANDO AVE STE 306
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5669
Practice Address - Country:US
Practice Address - Phone:407-529-4257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-06
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty