MEDICARE: SUNSHINE MENTAL SOLUTIONS 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	103TP2701X	Group Psychotherapy Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316506181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE MENTAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	1840 W 49TH ST STE 509
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2950
Country	:	US
Telephone Number	:	786-499-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 W 49TH ST STE 509
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-2950
Country	:	US
Telephone Number	:	786-499-8914
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MISS MARIELA GONZALEZ
Credential	:
Telephone Number	:	786-499-8914

Provider Enumeration Date	:	06/06/2019
Last Update Date	:	06/06/2019

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