Individual
SUNNY SIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
205 W MORGAN ST, BRANDON, FL 33510
(181) 339-8047
Mailing address
205 W MORGAN ST, BRANDON, FL 33510-4429
(813) 398-0470
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9315395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01690212
RR MEDICARE
FL
Enumeration date
02/25/2016
Last updated
08/20/2018
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