Sunrise Pharmacy of Kissimmee LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

30414 Issued in FL

Legal business name

SUNRISE PHARMACY OF KISSIMMEE LLC

Doing business as

Sunrise Pharmacy

Practice address

4543 Pleasant Hill Rd Ste D
Kissimmee, FL 34759-3406

Phone

(407) 343-4434

Fax

(407) 343-4435

NPI assigned

Nov 23, 2016

Last updated

Dec 8, 2018By 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

Vamsee Nalagandla

Title

Member/Manager

Phone

(407) 343-4434

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SUNRISE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544227200000",
    "number": "1588107528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 PLEASANT HILL RD STE D",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593406",
            "telephone_number": "407-343-4434",
            "fax_number": "407-343-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 PLEASANT HILL RD STE D",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593406",
            "telephone_number": "407-343-4434",
            "fax_number": "407-343-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE PHARMACY OF KISSIMMEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-23",
        "last_updated": "2018-12-08",
        "status": "A",
        "authorized_official_last_name": "NALAGANDLA",
        "authorized_official_first_name": "VAMSEE",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "407-343-4434"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "30414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2165964",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUNRISE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunapee Dialysis LLC (Celebration Dialysis)
• Carlos Adriano Suncal Jr.
• Sunny Transportation Corp
• Sunrise Healthcare Inc (Dr. Syed a. Jafri, M.D.)
• Sunrise Pharmacy of Kissimmee LLC (Sunrise Pharmacy)
• Sunrise Support Services LLC
• Sunshine Family & Wellness Center (sunshine family medical & wellness center)
• Sunshine Family Transport LLC
• Sunshine Homecare Services LLC
• Sunshine Physical Therapy & Fitness Center Inc

• Community/Retail Pharmacy in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.