Provider Demographics
NPI:1952429326
Name:SUNCOAST MEDICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:SUNCOAST MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZAVALA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:386-574-6079
Mailing Address - Street 1:601 DELTONA BLVD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-8017
Mailing Address - Country:US
Mailing Address - Phone:386-574-6079
Mailing Address - Fax:
Practice Address - Street 1:601 DELTONA BLVD
Practice Address - Street 2:SUITE #101
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-8017
Practice Address - Country:US
Practice Address - Phone:386-574-6079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3363OtherMEDICARE ID