MEDICARE: SUNSHINE FAMILY PSYCH & WELLNESS 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740914613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE FAMILY PSYCH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	4388 COMMERCIAL WAY
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-1965
Country	:	US
Telephone Number	:	727-278-6445
Fax Number	:	813-762-1388

Provider Business Practice Location Address
First Line	:	4388 COMMERCIAL WAY
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34606-1965
Country	:	US
Telephone Number	:	727-278-6445
Fax Number	:	813-762-1388

Authorized Official
Title or Position	:	OWNER/ ARNP
Name	:	MRS. KIMBERLY MARIE HYMILLER
Credential	:	MSN, ARNP, FNP-C
Telephone Number	:	727-278-6445

Provider Enumeration Date	:	07/14/2022
Last Update Date	:	08/08/2023

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Directions to “SUNSHINE FAMILY PSYCH & WELLNESS LLC ” Practice Location

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