MEDICARE: SUNSHINE CARE PROVIDERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1083139364
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE CARE PROVIDERS LLC

Provider Business Mailing Address
First Line	:	912 SKOGLUND CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1137
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 SKOGLUND CIR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1137
Country	:	US
Telephone Number	:	702-415-4947
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LUISITO ESPANOLA
Credential	:
Telephone Number	:	702-415-4947

Provider Enumeration Date	:	08/08/2017
Last Update Date	:	08/08/2017

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