Provider Demographics
NPI:1134554678
Name:SUNCARE ORTHOPAEDICS
Entity type:Organization
Organization Name:SUNCARE ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-302-1733
Mailing Address - Street 1:8370 W HILLSBOROUGH AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3898
Mailing Address - Country:US
Mailing Address - Phone:813-302-1733
Mailing Address - Fax:813-881-1801
Practice Address - Street 1:8370 W HILLSBOROUGH AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3898
Practice Address - Country:US
Practice Address - Phone:813-302-1733
Practice Address - Fax:813-881-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9141207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL37616YMedicare PIN
FLL15209Medicare UPIN