Provider Demographics
NPI:1356593081
Name:SUNSHINE HEALTH NETWORK, INC
Entity type:Organization
Organization Name:SUNSHINE HEALTH NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:PROSPERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-732-7855
Mailing Address - Street 1:15321 S DIXIE HWY STE 309
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1873
Mailing Address - Country:US
Mailing Address - Phone:786-732-7855
Mailing Address - Fax:786-732-7809
Practice Address - Street 1:15321 S DIXIE HWY STE 206
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1814
Practice Address - Country:US
Practice Address - Phone:786-732-7855
Practice Address - Fax:786-732-7809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-13
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X, 225X00000X
FLSA3280235Z00000X
FLMH6701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000540800Medicaid