Provider Demographics
NPI:1467296889
Name:SUNPALM HEALTHCARE LLC
Entity type:Organization
Organization Name:SUNPALM HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:321-344-8222
Mailing Address - Street 1:2195 ROBERT J CONLAN BLVD NE APT 403
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2780
Mailing Address - Country:US
Mailing Address - Phone:321-344-8222
Mailing Address - Fax:
Practice Address - Street 1:2195 ROBERT J CONLAN BLVD NE APT 403
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2780
Practice Address - Country:US
Practice Address - Phone:321-344-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care