Healthcare Provider Details

I. General information

NPI: 1003749128
Provider Name (Legal Business Name): SUNSHINE SUPPORTIVE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
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: 786-536-2013
Mailing address:
  • Phone: 786-536-2012
  • Fax: 786-536-2013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WIDAYESSI FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 786-536-2012