Sun Coast Surgical Suites LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUN COAST SURGICAL SUITES LLC

Practice address

12731 New Brittany Blvd
Fort Myers, FL 33907-3632

Phone

(954) 906-9536

Fax

(954) 302-8736

NPI assigned

Apr 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Allen Licht

Title

Managing Director

Phone

(954) 906-9536

Specialties & licenses 1

Addresses

Other names 1

• SUNCOAST SURGICAL SUITES Doing business as

Electronic endpoints 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1043955693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12350 NW 39TH ST STE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652418",
            "telephone_number": "954-906-9536",
            "fax_number": "954-302-8736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12731 NEW BRITTANY BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073632",
            "telephone_number": "954-906-9536",
            "fax_number": "954-302-8736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN COAST SURGICAL SUITES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "LICHT",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "954-906-9536",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "legal@athena-medical.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12350 NW 39th St Ste 200",
            "city": "Coral Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330652418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "SUNCOAST SURGICAL SUITES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kimberly Sumner
• Stephanie Sump
• Sunburst Cardiology LLC
• Suncoast Injury Centers LLC
• Suncoast Integrated Medical Center LLC
• Suncoast Surgery Center, LLC
• Suncoast Vascular Clinic

• Ambulatory Surgical Clinic/Center in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.