Provider Demographics
NPI:1740074780
Name:SUNSHINE INFECTIOUS DISEASE ASSOCIATES PLLC
Entity type:Organization
Organization Name:SUNSHINE INFECTIOUS DISEASE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIDYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOLLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-836-3984
Mailing Address - Street 1:1462 NW 136TH TER
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-0229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1813 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-8167
Practice Address - Country:US
Practice Address - Phone:408-836-3984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty