Provider Demographics
NPI:1679578074
Name:SUNSHINE GOOD CARE, LLC
Entity Type:Organization
Organization Name:SUNSHINE GOOD CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:YURIY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHVARTSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-454-0496
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:STE 801
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3772
Mailing Address - Country:US
Mailing Address - Phone:954-454-0496
Mailing Address - Fax:954-454-0985
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD
Practice Address - Street 2:STE 801
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3772
Practice Address - Country:US
Practice Address - Phone:954-454-0496
Practice Address - Fax:954-454-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108159Medicare ID - Type Unspecified