Sunshine Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME106343 Issued in FL

Legal business name

SUNSHINE PRIMARY CARE LLC

Practice address

17921 Hunting Bow Cir
Suite 101
Lutz, FL 33558-5379

Phone

(813) 792-1900

NPI assigned

Mar 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Ghiath Kashlan, MDNPI 1053393561

Title

Owner/Provider/Ceo

Phone

(813) 792-1900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Ghiath Kashlan, MD

  • Internal Medicine Physician
  • Trinity, FL
  • NPI 1053393561
  Medicare reassignment Authorized official
• Tracy Marx-Renner, LPN

  • Licensed Practical Nurse
  • Lutz, FL
  • NPI 1104335355
  NPD (past)
• Alexandra Jane Whirle, APRN

  • Primary Care Nurse Practitioner
  • Lutz, FL
  • NPI 1225713290
  NPD (past)

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

{
    "created_epoch": "1363478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1861734824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17921 HUNTING BOW CIR",
            "address_2": "SUITE 101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585379",
            "telephone_number": "813-792-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17921 HUNTING BOW CIR",
            "address_2": "SUITE 101",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585379",
            "telephone_number": "813-792-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-17",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "KASHLAN",
        "authorized_official_first_name": "GHIATH",
        "authorized_official_title_or_position": "OWNER/PROVIDER/CEO",
        "authorized_official_telephone_number": "813-792-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME106343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suncoast U R L L C
• Suncoast Ur Inc
• Sunlake Pain Management, LLC (Sunlake Medical Associates)
• Sunny Side Up Therapy and Consulting, LLC
• Sunshine Family Psych & Wellness LLC
• Support Associates of Tampa Bay, Inc
• Supported Employment and Living Facilitators, Inc. (SELF, Inc.)
• Neil Hans Surti, M.D.
• Subatha Suthakaran
• Samantha Elisabeth Sutton

• Internal Medicine Physician in Lutz, FL
• Providers in Lutz, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.