Provider Demographics
NPI:1457032294
Name:SUNSHINE TELEMEDICINE, INC.
Entity Type:Organization
Organization Name:SUNSHINE TELEMEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGEH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARSOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-543-4077
Mailing Address - Street 1:1572 LARAMIE CIR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6371
Mailing Address - Country:US
Mailing Address - Phone:321-544-7870
Mailing Address - Fax:321-559-6644
Practice Address - Street 1:1572 LARAMIE CIR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6371
Practice Address - Country:US
Practice Address - Phone:321-543-4077
Practice Address - Fax:321-559-6644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty