Provider Demographics
NPI:1669757472
Name:SUNSET PEDIATRICS, LLC
Entity type:Organization
Organization Name:SUNSET PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-661-1962
Mailing Address - Street 1:7300 SW 62ND PL
Mailing Address - Street 2:PENTHOUSE-WEST
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4806
Mailing Address - Country:US
Mailing Address - Phone:305-661-1962
Mailing Address - Fax:305-661-6112
Practice Address - Street 1:7300 SW 62ND PL
Practice Address - Street 2:PENTHOUSE-WEST
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4806
Practice Address - Country:US
Practice Address - Phone:305-661-1962
Practice Address - Fax:305-661-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL83179208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134182470OtherNPI
1871816637OtherNPI