Organization
SUNDARI PLASTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BARRY ROACH JR. D.O. (PRESIDENT)
(727) 378-5808
Entity
Organization
Contact information
Practice address
14100 FIVAY RD, SUITE 130, HUDSON, FL 34667-7180
(727) 378-5808
(727) 378-5810
Mailing address
PO BOX 5441, HUDSON, FL 34674-5441
(727) 378-5808
(727) 378-5810
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
OS9566
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
OS9566
FL
Other
Enumeration date
08/12/2008
Last updated
04/19/2011
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