Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0100X | Gastroenterologist | MD2015-0529 | NM |
Y | 207RG0100X | Gastroenterologist | ME142598 | FL |
NPI | 1013165083 |
---|---|
Provider Name | Dr. Joseph K Sunny JR. |
First Address | Miami, FL 33130-2956 |
Second Address | Miami, FL 33130-2956 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 08/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104955500 | (05) | FL |
L1464 | FL MEDICARE (01) | FL |