NPIMap

Organization Active NPI

Sunrise Medical Group Inc

  • Neurology Physician
  • Hollywood, FL
National Provider Identifier
1912957697
Registry record updated Dec 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SUNRISE MEDICAL GROUP INC
Practice address
4925 Sheridan St
200
Hollywood, FL 33021-2829
Phone
(954) 981-3850
Fax
(954) 981-3889
NPI assigned
May 11, 2006
Organization subpart
Yes
Parent organization
UNIVERSAL MEDICAL CONCEPTS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2009

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

Authorized official

Name
Giovanne Zygala
Title
Credentialing Manager
Phone
(954) 956-1966

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

4925 Sheridan St
200
Hollywood, FL 33021-2829

Mailing address

6245 N Federal Hwy
Suite 300
Fort Lauderdale, FL 33308-1998
Phone (954) 956-1966

Other identifiers 7

IdentifierTypeStateIssuer
258676203MedicaidFL
258676205MedicaidFL
258676201MedicaidFL
258676204MedicaidFL
258676200MedicaidFL
258676202MedicaidFL
258676206MedicaidFL

National Provider Directory

National Provider Directory

Locations

9750 NW 33rd St
Ste 107
Coral Springs, FL 33065
Phone (954) 341-1171

1625 SE 3rd Ave
Ste 620
Ft Lauderdale, FL 33316
Phone (954) 320-3380

407 SE 9th St
Ste 102
Ft Lauderdale, FL 33316
Phone (954) 981-3850

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

6245 N Federal Hwy
Ste 300
Ft Lauderdale, FL 33308

16800 NW 2nd Ave
Ste 601
North Miami Beach, FL 33169
Phone (305) 652-3062

333 NW 70th Ave
Ste 103
Plantation, FL 33317
Phone (954) 797-7887

7225 N University Dr
Ste 102
Tamarac, FL 33321
Phone (954) 718-9777

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1912957697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 N FEDERAL HWY",
            "address_2": "SUITE 300",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081998",
            "telephone_number": "954-956-1966",
            "fax_number": "954-745-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 SHERIDAN ST",
            "address_2": "200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212829",
            "telephone_number": "954-981-3850",
            "fax_number": "954-981-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSAL MEDICAL CONCEPTS INC",
        "enumeration_date": "2006-05-11",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "ZYGALA",
        "authorized_official_first_name": "GIOVANNE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "954-956-1966"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676205",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676204",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258676206",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; 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.