Sunshine State Surgical Specialists PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME88645 Issued in FL

Legal business name

SUNSHINE STATE SURGICAL SPECIALISTS PA

Practice address

1879 Nightingale Lane
Suite B3
Tavares, FL 32778

Phone

(352) 742-1300

Fax

(352) 742-1305

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

David S Bjerken, MD

Title

Owner

Phone

(352) 742-1300

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Dennis Harkness, PA-C

  • Physician Assistant
  • Tavares, FL
  • NPI 1811995889
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1437184090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-742-1300",
            "fax_number": "352-742-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 NIGHTINGALE LANE",
            "address_2": "SUITE B3",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-742-1300",
            "fax_number": "352-742-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE STATE SURGICAL SPECIALISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "BJERKEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-742-1300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME88645",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME88645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Stephens, APRN, PMHNP-BC
• Alyssa Marie Stewart
• Amanda Stickney, M.A., L.M.H.C.
• Michelle Lynn Stone
• Amber Sullins
• Supportive Companions Home Care LLC
• Jessica Nadona Sweet, MS, CCC-SLP
• Bao Trung Ta
• Eva Takacs-Dilorenzo, MD
• Takita S. Hayes

• Surgery Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.