Provider Demographics
NPI:1255571774
Name:SUNRISE HEALTHCARE INC
Entity type:Organization
Organization Name:SUNRISE HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAFRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-496-2051
Mailing Address - Street 1:2151 LANGLEY CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5943
Mailing Address - Country:US
Mailing Address - Phone:888-504-7097
Mailing Address - Fax:888-771-3118
Practice Address - Street 1:721 OAK COMMONS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4186
Practice Address - Country:US
Practice Address - Phone:888-504-7097
Practice Address - Fax:888-771-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79297207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000849900Medicaid
FL000849900Medicaid