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Organization
SUNRISE PRIMARY CARE INC
Active
Organization
SUNRISE PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBINO GAW (ADMINISTRATOR)
(386) 698-2279
Entity
Organization
Contact information
Practice address
811 N SUMMIT ST, CRESCENT CITY, FL 32112-2109
(386) 698-2279
(386) 698-2239
Mailing address
PO BOX 249, PALATKA, FL 32178-0249
(386) 698-2279
(386) 698-2239
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME076342
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
660181201
—
FL
Enumeration date
05/01/2008
Last updated
05/01/2008
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