Sunstate Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUNSTATE PEDIATRICS

Practice address

758 N Sun Dr Ste 108
Lake Mary, FL 32746-2599

Phone

(407) 333-2809

Fax

(407) 333-2870

NPI assigned

Jun 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ehteram Raissi-Fard, MDNPI 1588650576

Title

President

Phone

(407) 333-2809

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ehteram Raissi-Fard, MD

  • Pediatrics Physician
  • Lake Mary, FL
  • NPI 1588650576
  NPD (past) Authorized official

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1902067879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 N SUN DR STE 108",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462599",
            "telephone_number": "407-333-2809",
            "fax_number": "407-333-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 N SUN DR STE 108",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462599",
            "telephone_number": "407-333-2809",
            "fax_number": "407-333-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSTATE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "RAISSI-FARD",
        "authorized_official_first_name": "EHTERAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-333-2809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Christine Sullivan, MS, CCC-SLP
• Keri Sullivan
• Cindy Summers, LPTA
• Summerville 3, LLC (Brookdale Lake Mary)
• Sunshine Walk- in
• Sunstatemedical Associates PA
• Supreme Therapy, LLC
• Shaveta Suri, M.A.
• Gabriella Lovaleen Sutton
• Robert E Sutton, M.D.

• Pediatrics Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.