Provider Demographics
NPI:1962825786
Name:SUNSHINE FAMILY CARE LLC
Entity Type:Organization
Organization Name:SUNSHINE FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISMAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-229-1858
Mailing Address - Street 1:PO BOX 771077
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34477-1077
Mailing Address - Country:US
Mailing Address - Phone:352-229-1858
Mailing Address - Fax:
Practice Address - Street 1:4143 SW 51ST CT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-9695
Practice Address - Country:US
Practice Address - Phone:352-229-1858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME102405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty