Organization Active NPI

Sunshine State Medical Clinic PA

  • Internal Medicine Physician
  • Ocala, FL
National Provider Identifier
1669559423
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SUNSHINE STATE MEDICAL CLINIC PA
Practice address
6075 SW 73Rd Street Road
Ocala, FL 34476
Phone
(352) 369-5440
Fax
(352) 369-4249
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Vday S Mishra, MD
Title
President
Phone
(352) 369-5440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

6075 SW 73Rd Street Road
Ocala, FL 34476

Mailing address

6075 SW 73Rd Street Road
Ocala, FL 34476
Phone (352) 369-5440

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0962181Sunshine State Medical Clinic PA6075 SW 73Rd St Rd, Ocala, FL 34476Certificate of waiverApr 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Sunshine State Medical Clinic2 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.

Locations

6075 SW 73rd Street Rd
Ocala, FL 34476
Phone (352) 369-5440

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669559423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 SW 73RD STREET ROAD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34476",
            "telephone_number": "352-369-5440",
            "fax_number": "352-369-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6075 SW 73RD STREET ROAD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "34476",
            "telephone_number": "352-369-5440",
            "fax_number": "352-369-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE STATE MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MISHRA",
        "authorized_official_first_name": "VDAY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-369-5440",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.