Healthcare Provider Details

I. General information

NPI: 1942174776
Provider Name (Legal Business Name): SUNSHINE PHARMACY OF LONGWOOD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 S US HIGHWAY 17 92
LONGWOOD FL
32750-5711
US

IV. Provider business mailing address

876 S US HIGHWAY 17 92
LONGWOOD FL
32750-5711
US

V. Phone/Fax

Practice location:
  • Phone: 407-790-7254
  • Fax: 321-295-7978
Mailing address:
  • Phone: 407-790-7254
  • Fax: 321-295-7978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CHARANJIT KAUR SODHI
Title or Position: OWNER
Credential:
Phone: 407-474-4441