Provider Demographics
NPI:1780794719
Name:SUNBEAM HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:SUNBEAM HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOJISOLA
Authorized Official - Middle Name:O
Authorized Official - Last Name:ABIDOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:904-762-1528
Mailing Address - Street 1:1916 UNIVERSITY BLVD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-4526
Mailing Address - Country:US
Mailing Address - Phone:904-762-1528
Mailing Address - Fax:904-762-1477
Practice Address - Street 1:1916 UNIVERSITY BLVD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-4526
Practice Address - Country:US
Practice Address - Phone:904-762-1528
Practice Address - Fax:904-762-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health