Healthcare Provider Details
I. General information
NPI: 1740914613
Provider Name (Legal Business Name): SUNSHINE FAMILY PSYCH & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2022
Last Update Date: 08/08/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4388 COMMERCIAL WAY
SPRING HILL FL
34606-1965
US
IV. Provider business mailing address
4388 COMMERCIAL WAY
SPRING HILL FL
34606-1965
US
V. Phone/Fax
- Phone: 727-278-6445
- Fax: 813-762-1388
- Phone: 727-278-6445
- Fax: 813-762-1388
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KIMBERLY
MARIE
HYMILLER
Title or Position: OWNER/ ARNP
Credential: MSN, ARNP, FNP-C
Phone: 727-278-6445