Provider Demographics
NPI:1083852545
Name:SUNSHINE MEDICAL AT PALM, INC.
Entity Type:Organization
Organization Name:SUNSHINE MEDICAL AT PALM, INC.
Other - Org Name:PALM MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:239-262-6592
Mailing Address - Street 1:411 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5806
Mailing Address - Country:US
Mailing Address - Phone:239-262-6592
Mailing Address - Fax:239-262-8663
Practice Address - Street 1:411 9TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5806
Practice Address - Country:US
Practice Address - Phone:239-262-6592
Practice Address - Fax:239-262-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6181420001Medicare NSC