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General NPI Number Information
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NPI Number | 1992496608
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Entity Type | Organization
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Legal Business Name | SHINESUN PROVIDER PLACEMENT SERVICES LLC
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 260 PEACHTREE ST NW STE 2200
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City | ATLANTA
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State | GA
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Zip | 30303-1292
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Country | US
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Telephone | 404-919-8096
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Fax |
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Provider Business Mailing Address
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Address Line | 3426 SW SAN BENITO ST
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City | PORT ST LUCIE
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State | FL
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Zip | 34953-3732
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Country | US
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Telephone | 772-301-5061
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEEVE RUBBENS NICOLAS
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Credential |
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Telephone | 772-301-5061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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