MEDICARE: SUNSHINE SOCIAL SERVICES, INC.

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	101YM0800X	Mental Health Counselor	MH7969	FL
2	1041C0700X	Clinical Social Worker	SW6037	FL
3	1041C0700X	Clinical Social Worker	SW9061	FL
4	1041C0700X	Clinical Social Worker	SW7943	FL
5	385H00000X	Respite Care	9013	FL
6	251S00000X	Community/Behavioral Health Agency	N/A	FL

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	:	1780910968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE SOCIAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	1480 SW 9TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1375
Country	:	US
Telephone Number	:	954-764-5150
Fax Number	:	954-764-5143

Provider Business Practice Location Address
First Line	:	1480 SW 9TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33315-1375
Country	:	US
Telephone Number	:	954-764-5150
Fax Number	:	954-764-5143

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MARK ADLER
Credential	:	M.P.H.
Telephone Number	:	954-764-5150

Provider Enumeration Date	:	10/23/2009
Last Update Date	:	11/19/2009

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Directions to “SUNSHINE SOCIAL SERVICES, INC. ” Practice Location

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