| NPI | 1114153483 |
|---|---|
| Doing Business As | SUNLAKE MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | LUIS A. LOGRONO Medical Director 813-948-2107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: FL HCC8458) |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2010-04-01 |