Healthcare Provider Details

I. General information

NPI: 1194393660
Provider Name (Legal Business Name): SUNSHINE BEHAVIORAL HEALTH SERVICES, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103400 OVERSEAS HWY STE 240
KEY LARGO FL
33037-2849
US

IV. Provider business mailing address

PO BOX 972377
MIAMI FL
33197-2377
US

V. Phone/Fax

Practice location:
  • Phone: 305-998-4248
  • Fax: 786-265-0977
Mailing address:
  • Phone: 305-998-4248
  • Fax: 786-265-0977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LUIS MANUEL RODRIGUEZ
Title or Position: DIRECTOR OF EXECUTIVE SERVICES
Credential:
Phone: 305-998-4248