MEDICARE: AH SUNSHINEENTERPRISES 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	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1952800328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AH SUNSHINEENTERPRISES INC

Provider Business Mailing Address
First Line	:	6735 CONROY RD STE 326
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3568
Country	:	US
Telephone Number	:	407-614-6255
Fax Number	:

Provider Business Practice Location Address
First Line	:	6735 CONROY RD STE 326
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-3568
Country	:	US
Telephone Number	:	407-614-6255
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGEMENT
Name	:	MRS. LISETT GONZALEZ
Credential	:
Telephone Number	:	407-614-6255

Provider Enumeration Date	:	02/12/2018
Last Update Date	:	02/12/2018

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