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Organization

GOLDEN SUN BEAR, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES HILGER (CHIEF ACCOUNTING OFFICER)
(253) 280-9501
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
2085R0204X
Vascular & Interventional Radiology Physician
2086S0129X
Vascular Surgery Physician
Primary

Other

Enumeration date
10/25/2011
Last updated
01/05/2012
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