# SUNSHINE WALK IN CLINIC

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

## Provider details

- **NPI number:** 1790948941
- **Authorized official:** DR. NAGEH S. BARSOUM MD (PRESIDENT)
- **Authorized official phone:** (321) 729-1400

## Contact information

- **Practice address:** 5205 BABCOCK ST NE, SUITE 3, PALM BAY, FL 32905-4638
- **Practice address phone:** (321) 729-1400
- **Practice address fax:** (321) 728-5700
- **Mailing address:** 5205 BABCOCK ST NE, SUITE 3, PALM BAY, FL 32905-4638
- **Mailing address phone:** (321) 729-1400
- **Mailing address fax:** (321) 728-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2008
- **Last updated:** 07/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 264156900 | — | FL |
| 05 | — | 264156901 | — | FL |