Provider Demographics
NPI:1447076708
Name:SUNSHINE BEHAVIOR HEALTH CARE INC
Entity type:Organization
Organization Name:SUNSHINE BEHAVIOR HEALTH CARE INC
Other - Org Name:<UNAVAIL>
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:
Authorized Official - Phone:786-536-2012
Mailing Address - Street 1:2550 NW 72ND AVE STE 115-117
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2550 NW 72ND AVE STE 115-117
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1350
Practice Address - Country:US
Practice Address - Phone:786-536-2012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSHINE BEHAVIOR HEALTH CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health