Organization
SUNSHINE STATE SURGICAL SPECIALISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S BJERKEN MD (OWNER)
(352) 742-1300
Entity
Organization
Contact information
Practice address
1879 NIGHTINGALE LANE, SUITE B3, TAVARES, FL 32778
(352) 742-1300
(352) 742-1305
Mailing address
PO BOX 547, TAVARES, FL 32778
(352) 742-1300
(352) 742-1305
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME88645
FL
2086S0129X
Vascular Surgery Physician
ME88645
FL
Other
Enumeration date
07/12/2006
Last updated
01/24/2008
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