# GOLDEN SUN BEAR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003192915
- **Authorized official:** JAMES HILGER (CHIEF ACCOUNTING OFFICER)
- **Authorized official phone:** (253) 280-9501

## Contact information

- **Practice address:** 13083 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0926
- **Practice address phone:** (813) 971-3064
- **Practice address fax:** (813) 977-3607
- **Mailing address:** 3 HAWTHORN PKWY, SUITE 410, VERNON HILLS, IL 60061-1446
- **Mailing address phone:** (847) 949-3845
- **Mailing address fax:** (866) 408-5072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RN0300X | Nephrology Physician | — | NULL | — |
| 207RN0300X | Nephrology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2011
- **Last updated:** 01/05/2012