Organization
SUNLIFE PEDIATRIC NETWORK INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA LOPEZ (OFFICE MANAGER)
(954) 889-4029
Entity
Organization
Contact information
Practice address
10051 PINES BLVD STE A, PEMBROKE PINES, FL 33024-6187
(954) 743-2996
(954) 558-9213
Mailing address
10051 PINES BLVD STE A, PEMBROKE PINES, FL 33024-6187
(954) 743-2996
(954) 589-2131
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
ME 68933
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
378537800
—
FL
Enumeration date
05/07/2007
Last updated
09/11/2019
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