Provider Demographics
NPI:1013230333
Name:FLORIDA SUNSHINE HOME MEDICAL, INC.
Entity Type:Organization
Organization Name:FLORIDA SUNSHINE HOME MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GHOLSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:954-358-1450
Mailing Address - Street 1:1999 NW 55TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-3702
Mailing Address - Country:US
Mailing Address - Phone:954-933-1342
Mailing Address - Fax:954-933-1447
Practice Address - Street 1:1999 NW 55TH AVE
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-3702
Practice Address - Country:US
Practice Address - Phone:954-933-1342
Practice Address - Fax:954-933-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1313630332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies