Healthcare Provider Details

I. General information

NPI: 1841126729
Provider Name (Legal Business Name): FLORIDA SUNSET HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 NW 39TH ST
CAPE CORAL FL
33993-7853
US

IV. Provider business mailing address

1631 DEL PRADO BLVD S STE 300
CAPE CORAL FL
33990-6740
US

V. Phone/Fax

Practice location:
  • Phone: 786-577-2018
  • Fax: 786-957-5159
Mailing address:
  • Phone: 786-577-2018
  • Fax: 786-957-5158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AGUSTIN RODOLFO LOPEZ LEIROS
Title or Position: OWNER
Credential: APRN
Phone: 786-218-5814