Provider Demographics
NPI:1730295312
Name:SUNSHINE TEAM SUPPLY INC
Entity Type:Organization
Organization Name:SUNSHINE TEAM SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EREDIO
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-278-4496
Mailing Address - Street 1:18710 SW 107TH AVE
Mailing Address - Street 2:SUITE 24
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6742
Mailing Address - Country:US
Mailing Address - Phone:305-278-4496
Mailing Address - Fax:305-278-4497
Practice Address - Street 1:18710 SW 107TH AVE
Practice Address - Street 2:SUITE 24
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-6742
Practice Address - Country:US
Practice Address - Phone:305-278-4496
Practice Address - Fax:305-278-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3204744OtherOXYGEN RETAILER
FL1313078OtherHME STATE LICENSE