Provider Demographics
NPI:1770782211
Name:SUNSHINE MEDICAL CARE INC
Entity type:Organization
Organization Name:SUNSHINE MEDICAL CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGEH
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARSOUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-632-7520
Mailing Address - Street 1:3260 MURRELL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4569
Mailing Address - Country:US
Mailing Address - Phone:321-632-7520
Mailing Address - Fax:321-632-8092
Practice Address - Street 1:3260 MURRELL RD STE 102
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-4569
Practice Address - Country:US
Practice Address - Phone:321-632-7520
Practice Address - Fax:321-632-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-14
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81897208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H98623Medicare UPIN
FLU1867XMedicare PIN
U1867YMedicare PIN
FLU1867XMedicare PIN
U1867ZMedicare PIN