Organization Active NPI

Sunstate Managed Care LLC

  • Family Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1164875290
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUNSTATE MANAGED CARE LLC
Practice address
3820 Tampa Road
Suite 202
Palm Harbor, FL 34684-3609
Phone
(727) 785-4540
Fax
(727) 781-7900
NPI assigned
Jul 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Cheryl Payne
Title
Cfo
Phone
(727) 785-4540

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3820 Tampa Road
Suite 202
Palm Harbor, FL 34684-3609

Mailing address

PO Box 566
Palm Harbor, FL 34682-0566
Phone (727) 785-4540

National Provider Directory

National Provider Directory

Locations

3820 Tampa Rd
Ste 102
Palm Harbor, FL 34684
Phone (727) 785-4540

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1164875290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346820566",
            "telephone_number": "727-785-4540",
            "fax_number": "727-481-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 TAMPA ROAD",
            "address_2": "SUITE 202",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843609",
            "telephone_number": "727-785-4540",
            "fax_number": "727-781-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSTATE MANAGED CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-785-4540"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2016; 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.