Provider Demographics
NPI:1518635408
Name:SUNSHINE SOUTH MED SUPPLY LLC
Entity Type:Organization
Organization Name:SUNSHINE SOUTH MED SUPPLY LLC
Other - Org Name:SUNSHINE SOUTH MED SUPPLY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MNGR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-438-8050
Mailing Address - Street 1:15715 S DIXIE HWY STE 320
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1883
Mailing Address - Country:US
Mailing Address - Phone:786-438-8050
Mailing Address - Fax:
Practice Address - Street 1:15715 S DIXIE HWY STE 320
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-1883
Practice Address - Country:US
Practice Address - Phone:786-438-8050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies