MEDICARE: SUNSHINE BEHAVIORAL SERVICES

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	251S00000X	Community/Behavioral Health Agency	05-1856	FL

General Provider Information

NPI Number	:	1124328588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE BEHAVIORAL SERVICES

Provider Business Mailing Address
First Line	:	9612 SW 118TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2714
Country	:	US
Telephone Number	:	786-267-2417
Fax Number	:	305-271-6969

Provider Business Practice Location Address
First Line	:	9612 SW 118TH PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-2714
Country	:	US
Telephone Number	:	786-267-2417
Fax Number	:	305-271-6969

Authorized Official
Title or Position	:	OWNER/ DIRECTOR
Name	:	MR. GERMAN LUNA
Credential	:	BCABA
Telephone Number	:	786-267-2417

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	11/01/2010

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