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General NPI Number Information
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NPI Number | 1457935033
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Entity Type | Organization
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Legal Business Name | SUNSHINE HEALTHCARE GROUP, LLC
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 1665 MARTIN LUTHER KING JR BLVD STE 12A
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City | RIVIERA BEACH
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State | FL
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Zip | 33404-7126
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Country | US
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Telephone | 561-267-1447
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Fax | 561-763-7380
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Provider Business Mailing Address
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Address Line | PO BOX 10868
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City | RIVIERA BEACH
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State | FL
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Zip | 33419-0868
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Country | US
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Telephone | 561-267-1447
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Fax | 561-763-7380
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. JAMAL GHANEM
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Credential |
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Telephone | 561-267-1447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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