MEDICARE: SUN CARE SERVICES OF SO FL CORP

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	332B00000X	Durable Medical Equipment & Medical Supplies	1141	FL
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	1141	FL
3	332BX2000X	Oxygen Equipment & Supplies (DME)	1141	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1209900001	OTHER	FL	DMERC SUPPLIER NUMBER

General Provider Information

NPI Number	:	1104923481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN CARE SERVICES OF SO FL CORP

Provider Business Mailing Address
First Line	:	9880 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3912
Country	:	US
Telephone Number	:	305-228-1488
Fax Number	:	305-228-8969

Provider Business Practice Location Address
First Line	:	9880 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33165-3912
Country	:	US
Telephone Number	:	305-228-1488
Fax Number	:	305-228-8969

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OSVALDO OLBERA
Credential	:
Telephone Number	:	305-228-1488

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	09/11/2025

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Directions to “SUN CARE SERVICES OF SO FL CORP ” Practice Location

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