Organization
SUNSHINE THORACIC SURGERY PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH M FUGARO M.D. (OWNER)
(863) 422-0022
Entity
Organization
Contact information
Practice address
121 WEBB DR, SUITE #300, DAVENPORT, FL 33837-3904
(863) 422-0022
(863) 422-1005
Mailing address
121 WEBB DR, SUITE #300, DAVENPORT, FL 33837-3904
(863) 422-0022
(863) 422-1005
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME 101026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201257300
—
MO
05
—
281007700
—
FL
Enumeration date
03/19/2008
Last updated
05/16/2008
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