Provider Demographics
NPI:1023063310
Name:SONSHINE MEDICAL AND SURGICAL SUPPLIES, INC
Entity type:Organization
Organization Name:SONSHINE MEDICAL AND SURGICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALENA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FANTETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-382-2606
Mailing Address - Street 1:3975 US 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5512
Mailing Address - Country:US
Mailing Address - Phone:863-382-2606
Mailing Address - Fax:
Practice Address - Street 1:3975 US 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5512
Practice Address - Country:US
Practice Address - Phone:863-382-2606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL32:00141332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0320020001Medicare NSC