MEDICARE: SUNSHINE STATE HOME HEALTH, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	299992632	FL

General Provider Information

NPI Number	:	1174700959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE STATE HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	8401 LAKE WORTH RD
Second Line	:	212
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2400
Country	:	US
Telephone Number	:	561-839-1919
Fax Number	:	561-839-1917

Provider Business Practice Location Address
First Line	:	8401 LAKE WORTH RD
Second Line	:	212
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-2400
Country	:	US
Telephone Number	:	561-839-1919
Fax Number	:	561-839-1917

Authorized Official
Title or Position	:	C.F.O.
Name	:	MR. BENSON BARRINGTON BARNES II
Credential	:
Telephone Number	:	561-839-1919

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	12/04/2012

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