Healthcare Provider Details

I. General information

NPI: 1114397866
Provider Name (Legal Business Name): SUNSHINE HEALTH CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2015
Last Update Date: 10/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11161 E STATE ROAD 70 SUITE 110-175
LAKEWOOD RANCH FL
34202-9407
US

IV. Provider business mailing address

11161 E STATE ROAD 70 SUITE 110-175
LAKEWOOD RANCH FL
34202-9407
US

V. Phone/Fax

Practice location:
  • Phone: 941-906-1881
  • Fax: 941-906-1190
Mailing address:
  • Phone: 941-906-1881
  • Fax: 941-906-1190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number234049
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number234049
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number234049
License Number StateFL

VIII. Authorized Official

Name: BARBARA COGSWELL
Title or Position: PRESIDENT
Credential:
Phone: 941-906-1881