Provider Demographics
NPI:1942175757
Name:SUNSHINE MEDICAL PRACTICES
Entity type:Organization
Organization Name:SUNSHINE MEDICAL PRACTICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WIDAYESSI
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-536-2012
Mailing Address - Street 1:2550 NW 72 AVE
Mailing Address - Street 2:115-117
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122
Mailing Address - Country:US
Mailing Address - Phone:786-536-2012
Mailing Address - Fax:786-536-2013
Practice Address - Street 1:2550 NW 72 AVE
Practice Address - Street 2:115-117
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122
Practice Address - Country:US
Practice Address - Phone:786-536-2012
Practice Address - Fax:786-536-2013
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSHINE BEHAVIOR HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care