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General NPI Number Information
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NPI Number | 1174029664
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Entity Type | Organization
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Legal Business Name | SUNSHINE PSYCHIATRY, LLC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 13100 WESTLINKS TER STE 8
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City | FORT MYERS
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State | FL
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Zip | 33913-8625
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Country | US
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Telephone | 239-202-0932
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Fax | 949-543-2509
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Provider Business Mailing Address
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Address Line | 13100 WESTLINKS TER STE 8
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City | FORT MYERS
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State | FL
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Zip | 33913-8625
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Country | US
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Telephone | 239-202-0932
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Fax | 949-543-2509
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. ROSA E SMITH
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Credential | ARNP
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Telephone | 239-202-0932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | SP014025
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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