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General NPI Number Information
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NPI Number | 1679578074
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Entity Type | Organization
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Legal Business Name | SUNSHINE GOOD CARE, LLC
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 1920 E HALLANDALE BEACH BLVD STE 801
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3772
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Country | US
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Telephone | 954-454-0496
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Fax | 954-454-0985
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Provider Business Mailing Address
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Address Line | 1920 E HALLANDALE BEACH BLVD STE 801
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-3772
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Country | US
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Telephone | 954-454-0496
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Fax | 954-454-0985
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. YURIY SHVARTSMAN
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Credential |
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Telephone | 954-454-0496
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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 | FL
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