# SUNLIFE OB-GYN SERVICES OF FT LAUDERDALE PA

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

## Provider details

- **NPI number:** 1679681449
- **Authorized official:** DR. WINSTON O BLISS MD (PRESIDENT)
- **Authorized official phone:** (954) 522-2979

## Contact information

- **Practice address:** 4101 NW 4TH ST, SUITE 306, PLANTATION, FL 33317-2840
- **Practice address phone:** (954) 522-2979
- **Practice address fax:** (954) 903-0633
- **Mailing address:** PO BOX 945953, ATLANTA, GA 30394-5953
- **Mailing address phone:** (954) 522-2979
- **Mailing address fax:** (954) 903-0633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | ME71138 | FL | Yes |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 07/10/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 276564100 | — | FL |