Sunrise Primary Care Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME076342 Issued in FL

Legal business name

SUNRISE PRIMARY CARE INC

Practice address

811 N Summit St
Crescent City, FL 32112-2109

Phone

(386) 698-2279

Fax

(386) 698-2239

NPI assigned

May 1, 2008

Organization subpart

No

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

Authorized official

Name

Albino Gaw

Title

Administrator

Phone

(386) 698-2279

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Sunrise Primary Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sunrise Primary Care Inc

  • Family Medicine Physician
  • Crescent City, FL
  • NPI 1346439965
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria-Josefina Santos Rivera, MD

  • Family Medicine Physician
  • Palatka, FL
  • NPI 1780686881
  NPD (past)

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1124294012",
    "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": "386-698-2279",
            "fax_number": "386-698-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N SUMMIT ST",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321122109",
            "telephone_number": "386-698-2279",
            "fax_number": "386-698-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "GAW",
        "authorized_official_first_name": "ALBINO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-698-2279"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME076342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660181201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaelea Faith Sexton
• Sleep Medicine Center Inc
• Southeast Sleep Consultants
• St John'S Recovery Place LLC
• Kylee Stoltzfus
• Sunrise Primary Care Inc
• Sunrise Primary Care Inc
• Sunrise Primary Care Inc
• T R Suggs MD Medical Clinic PA
• Mark Erik Tallaksen, D.C.

• Family Medicine Physician in Crescent City, FL
• Providers in Crescent City, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.