Organization
SUNSHINE PEDIATRIC CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN RUCKER MIHM M.D. (PHYSICIAN/MGR)
(941) 480-1639
Entity
Organization
Contact information
Practice address
145 MIAMI AVE EAST, VENICE, FL 34285
(941) 480-0088
(941) 480-0006
Mailing address
P.O BOX 1843, VENICE, FL 34284
(941) 480-0088
(941) 480-0006
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
0086844
FL
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
11/30/2011
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