Provider Demographics
NPI:1770071433
Name:SUNSHINE RHEUMATOLOGY AND ARTHRITIS CENTER LLC
Entity type:Organization
Organization Name:SUNSHINE RHEUMATOLOGY AND ARTHRITIS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RHEUMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VEDASHREE
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTHULU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-333-5080
Mailing Address - Street 1:938 CYPRESS VILLAGE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6835
Mailing Address - Country:US
Mailing Address - Phone:813-333-5080
Mailing Address - Fax:813-773-7717
Practice Address - Street 1:938 CYPRESS VILLAGE BLVD STE A
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-6835
Practice Address - Country:US
Practice Address - Phone:813-333-5080
Practice Address - Fax:813-773-7717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-28
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty