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General NPI Number Information
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NPI Number | 1043704612
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Entity Type | Organization
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Legal Business Name | SUNSHINE PREMIER HOME HEALTH AGENCY, LLC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 2710 S ORANGE BLOSSOM TRL STE 1/2
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City | ORLANDO
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State | FL
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Zip | 32805-6168
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Country | US
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Telephone | 407-949-2590
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Fax | 407-270-4338
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Provider Business Mailing Address
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Address Line | PO BOX 784472
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City | WINTER GARDEN
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State | FL
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Zip | 34778-4472
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Country | US
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Telephone | 407-730-2459
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MANDVIL LORISTON
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Credential |
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Telephone | 407-730-2459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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