Sun State Prosthetics Inc

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

PRO 12 Issued in FL

Legal business name

SUN STATE PROSTHETICS INC

Practice address

756 Berkshire Rd
Daytona Beach, FL 32114-1602

Phone

(407) 629-2866

Fax

(407) 629-4277

NPI assigned

Mar 26, 2007

Organization subpart

Yes

Parent organization

SUN STATE PROSTHETICS INCAs reported in NPPES

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

Authorized official

Name

Charles F Gano, LCP

Title

Owner

Phone

(407) 629-2866

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Sun State Prosthetics

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Sun State Prosthetics Inc.

  • Prosthetist
  • Winter Park, FL
  • NPI 1215954045
  NPPES parent name

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1194843797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1444 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894806",
            "telephone_number": "407-629-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 BERKSHIRE RD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141602",
            "telephone_number": "407-629-2866",
            "fax_number": "407-629-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN STATE PROSTHETICS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN STATE PROSTHETICS INC",
        "enumeration_date": "2007-03-26",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "GANO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-629-2866",
        "authorized_official_credential": "LCP"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": "FL",
            "license": "PRO 12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0662480002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daisy Suarez
• Maureen F. Suchenski, M.D.
• Brittany Amber Rachel Sue
• Jenni Helen Sujka
• Yolanda Sullivan, RN
• Kathleen Jing Sun, DDS
• Shuyan Sun
• Sunbelt Medical Supply & Oxygen, Inc.
• Suncoast New Options Frederick Avenue, LLC
• Suncoast Non- Emergency Transportation Corp.

• Prosthetist in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Prosthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.