Provider Demographics
NPI:1174029664
Name:SUNSHINE PSYCHIATRY, LLC
Entity Type:Organization
Organization Name:SUNSHINE PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:239-202-0932
Mailing Address - Street 1:13100 WESTLINKS TER STE 8
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8625
Mailing Address - Country:US
Mailing Address - Phone:239-202-0932
Mailing Address - Fax:949-543-2509
Practice Address - Street 1:13100 WESTLINKS TER STE 8
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8625
Practice Address - Country:US
Practice Address - Phone:239-202-0932
Practice Address - Fax:949-543-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSP014025261QM0850X
363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health