Healthcare Provider Details

I. General information

NPI: 1346950185
Provider Name (Legal Business Name): SUNSHINE BEHAVIOR HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 NW 72ND AVE STE 115-117
MIAMI FL
33122-1350
US

IV. Provider business mailing address

2550 NW 72ND AVE STE 115-117
MIAMI FL
33122-1350
US

V. Phone/Fax

Practice location:
  • Phone: 786-536-2012
  • Fax:
Mailing address:
  • Phone: 305-988-5332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: WIDAYESSI FERNANDEZ
Title or Position: PRESIDENT
Credential: APRN
Phone: 305-988-5332