Provider Demographics
NPI:1700214376
Name:SUNSHINE ELDERLY RESIDENCE CORP.
Entity Type:Organization
Organization Name:SUNSHINE ELDERLY RESIDENCE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-376-1018
Mailing Address - Street 1:870 N.E. 5 STREET
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:786-616-8505
Mailing Address - Fax:786-616-8493
Practice Address - Street 1:870 N.E. 5 STREET
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010
Practice Address - Country:US
Practice Address - Phone:786-616-8505
Practice Address - Fax:786-616-8493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10235310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility