Provider Demographics
NPI:1811499627
Name:SONSHINE CAREGIVERS/NURSE PROS
Entity type:Organization
Organization Name:SONSHINE CAREGIVERS/NURSE PROS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MIRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-346-0352
Mailing Address - Street 1:2110 W YONGE ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32505-5744
Mailing Address - Country:US
Mailing Address - Phone:850-764-6638
Mailing Address - Fax:850-266-7007
Practice Address - Street 1:2110 W YONGE ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32505-5744
Practice Address - Country:US
Practice Address - Phone:850-764-6638
Practice Address - Fax:850-266-7007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-07
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211952163W00000X, 251E00000X, 253Z00000X, 347C00000X, 363L00000X, 363LG0600X, 372600000X, 376J00000X, 385H00000X, 374U00000X
FL3163WH1000X, 376K00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty