Healthcare Provider Details

I. General information

NPI: 1023866373
Provider Name (Legal Business Name): SUNSHINE BETTER HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2024
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N # 31505
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

885 3RD AVE FL 28
NEW YORK NY
10022-4834
US

V. Phone/Fax

Practice location:
  • Phone: 305-204-1730
  • Fax:
Mailing address:
  • Phone: 305-204-1730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JUDZ DE LARA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 305-204-1730