Sunshine State Podiatry LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

3984 Issued in FL

Legal business name

SUNSHINE STATE PODIATRY LLC

Practice address

24830 Burnt Pine Dr Ste 3
Bonita Springs, FL 34134-1974

Phone

(239) 703-9301

NPI assigned

May 8, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Ann Fields, DPMNPI 1417362013

Title

Podiatrist

Phone

(239) 404-7793

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Stephanie Fields, DPM

  • Foot & Ankle Surgery Podiatrist
  • Miami, FL
  • NPI 1417362013

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Konstantin Agarunov, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • St Petersburg, FL
  • NPI 1194130211

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1700375458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8353 SW 124TH ST STE 206",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565847",
            "telephone_number": "239-703-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24830 BURNT PINE DR STE 3",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341974",
            "telephone_number": "239-703-9301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8353 SW 124th St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331565847",
            "country_code": "US",
            "telephone_number": "239-404-7793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNSHINE STATE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "239-404-7793",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "3984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "PO3990",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH FLORIDA",
            "identifier": "PO3984",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Bonita Springs, FL
• Providers in Bonita Springs, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.