Provider Demographics
NPI:1184895054
Name:SUNSHINE RADIOLOGY LLC
Entity type:Organization
Organization Name:SUNSHINE RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:COVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-299-1155
Mailing Address - Street 1:529 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3054
Mailing Address - Country:US
Mailing Address - Phone:863-299-1155
Mailing Address - Fax:863-299-1177
Practice Address - Street 1:529 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3054
Practice Address - Country:US
Practice Address - Phone:863-299-1155
Practice Address - Fax:863-299-1177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME553742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty