Provider Demographics
NPI:1205667227
Name:SUNSHINE MED TRANS LLC
Entity type:Organization
Organization Name:SUNSHINE MED TRANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLENILLA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:321-439-1061
Mailing Address - Street 1:2608 SPICEBUSH LOOP
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-6430
Mailing Address - Country:US
Mailing Address - Phone:321-439-1061
Mailing Address - Fax:
Practice Address - Street 1:2608 SPICEBUSH LOOP
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6430
Practice Address - Country:US
Practice Address - Phone:321-439-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)