Provider Demographics
NPI:1649693318
Name:SUNSHINE CARE
Entity type:Organization
Organization Name:SUNSHINE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDWAVIER PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMUDIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-860-5475
Mailing Address - Street 1:5324 P.O BOX
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32793-5324
Mailing Address - Country:US
Mailing Address - Phone:407-860-5475
Mailing Address - Fax:407-672-0866
Practice Address - Street 1:10821 FALLOW TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-2081
Practice Address - Country:US
Practice Address - Phone:407-860-5475
Practice Address - Fax:407-672-0866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000316500Medicaid
FL004122000Medicaid
FL003954900Medicaid
FL000316501Medicaid