Sunrise Primary Care Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME 76342 Issued in FL

Legal business name

SUNRISE PRIMARY CARE INC

Practice address

219 N Palm Ave
Palatka, FL 32177-2627

Phone

(386) 325-8002

Fax

(386) 325-8055

NPI assigned

Mar 3, 2007

Last updated

Jul 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Maria-Josefina S Rivera, M.D.

Title

Pres

Phone

(386) 325-8002

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sunrise Primary Care INC Other name

Locations

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1073642419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321780249",
            "telephone_number": "386-325-8002",
            "fax_number": "386-325-8055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 N PALM AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321772627",
            "telephone_number": "386-325-8002",
            "fax_number": "386-325-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-03",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MARIA-JOSEFINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "386-325-8002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME 76342",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 76342",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660236300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Primary Care INC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph Dean Stillword, MD
• John Sanders Stoltz, M.D.
• Abigale Rose Such, OTR
• Harold Hayes Sullivan Jr., MD, MPH
• Joseph Wynn Sullivan, D.O.
• Sunrise Primary Care Inc
• Siva Suryadevara, M.D.
• Kathleen Marie Tanner, LMT, LPN
• Lucien-Maximin Yanou Tchuisse, M.D.
• Ani Maria Tejada-Lipten, MD

• Primary Care Clinic/Center in Palatka, FL
• Providers in Palatka, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.