Sugars Supportive Services, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

001917900 Issued in FL

Legal business name

SUGARS SUPPORTIVE SERVICES, LLC

Practice address

2204 Citrus Blvd
Suite 10B
Leesburg, FL 34748-3019

Phone

(352) 435-4600

Fax

(352) 435-4605

NPI assigned

Aug 4, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Lorraine Adele Caldwell

Title

Owner

Phone

(352) 617-0400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1871979575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 CITRUS BLVD",
            "address_2": "SUITE 10B",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483019",
            "telephone_number": "352-435-4600",
            "fax_number": "352-435-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 CITRUS BLVD",
            "address_2": "SUITE 10B",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347483019",
            "telephone_number": "352-435-4600",
            "fax_number": "352-435-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGARS SUPPORTIVE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_middle_name": "ADELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-617-0400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "001917900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690259696",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001917900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Lewis Stroney, OT
• Linda R Struckmeyer, OTR
• Lisa Marie Sturgill, PTA
• Kevin Robert Suarez, PHARMD
• Kelly Sudnik, OTR
• Sujata S. Balulad, MD., PA
• Alayna Diane Sumner, PTA
• Keri Grace Sumner, PTA
• Sunrise Dental & Wellness Center PLLC
• Sunrisearc, Inc.

• Community Health Worker in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.