MEDICARE: SUNSHINE RD 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	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1194413880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE RD LLC

Provider Business Mailing Address
First Line	:	8385 101ST CT
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-2878
Country	:	US
Telephone Number	:	724-766-0389
Fax Number	:

Provider Business Practice Location Address
First Line	:	8385 101ST CT
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-3296
Country	:	US
Telephone Number	:	724-766-0389
Fax Number	:

Authorized Official
Title or Position	:	OWNER/REGISTERED DIETITIAN
Name	:	MS. TERESA ANN EURY
Credential	:	MPH, RDN, LDN
Telephone Number	:	724-766-0389

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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