MEDICARE: SUNSHINE PSYCHIATRIC CARE 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1427867308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE PSYCHIATRIC CARE LLC

Provider Business Mailing Address
First Line	:	9 OLD KINGS RD
Second Line	:	STE 123 #1012
City	:	PALM COAST
State	:	FL
Zip	:	32137
Country	:	US
Telephone Number	:	386-230-4448
Fax Number	:	386-343-7206

Provider Business Practice Location Address
First Line	:	160 CYPRESS POINT PKWY STE B302
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-8443
Country	:	US
Telephone Number	:	386-230-4448
Fax Number	:	386-343-7206

Authorized Official
Title or Position	:	OWNER
Name	:	RHONDA RICHARDSON
Credential	:	APRN
Telephone Number	:	386-230-4448

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	01/11/2025

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