Provider Demographics
NPI:1508689639
Name:SUNSHINE FAMILY PSYCH & WELLNESS LLC
Entity type:Organization
Organization Name:SUNSHINE FAMILY PSYCH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:404-370-2158
Mailing Address - Street 1:2927 PEARSON JAMES PL
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33559-6996
Mailing Address - Country:US
Mailing Address - Phone:813-991-4744
Mailing Address - Fax:813-907-5067
Practice Address - Street 1:2927 PEARSON JAMES PL
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33559-6996
Practice Address - Country:US
Practice Address - Phone:813-991-4744
Practice Address - Fax:813-907-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty