Provider Demographics
NPI:1972137826
Name:BREATH OF SUNSHINE SERVICES, INC
Entity Type:Organization
Organization Name:BREATH OF SUNSHINE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-501-2846
Mailing Address - Street 1:4456 TAMIAMI TRL STE B15
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-2136
Mailing Address - Country:US
Mailing Address - Phone:772-501-2846
Mailing Address - Fax:954-583-5949
Practice Address - Street 1:4456 TAMIAMI TRL STE B15
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33980-2136
Practice Address - Country:US
Practice Address - Phone:772-501-2846
Practice Address - Fax:954-583-5949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-01
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107597800Medicaid