Organization
SUNSHINE WALK IN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGEH S. BARSOUM MD (PRESIDENT)
(321) 729-1400
Entity
Organization
Contact information
Practice address
5205 BABCOCK ST NE, SUITE 3, PALM BAY, FL 32905-4638
(321) 729-1400
(321) 728-5700
Mailing address
5205 BABCOCK ST NE, SUITE 3, PALM BAY, FL 32905-4638
(321) 729-1400
(321) 728-5700
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264156900
—
FL
05
—
264156901
—
FL
Enumeration date
07/08/2008
Last updated
07/08/2008
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