| Sunshine Psychiatry, Llc | |
|
13100 Westlinks Ter Ste 8 Fort Myers FL 33913-8625 | |
| (239) 202-0932 | |
| (949) 543-2509 |
| Full Name | Sunshine Psychiatry, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 13100 Westlinks Ter Ste 8, Fort Myers, Florida |
| Authorized Official Name and Position | Rosa E Smith (OWNER/CEO) |
| Authorized Official Contact | 2392020932 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunshine Psychiatry, Llc 13100 Westlinks Ter Ste 8 Fort Myers FL 33913-8625 Ph: (239) 202-0932 | Sunshine Psychiatry, Llc 13100 Westlinks Ter Ste 8 Fort Myers FL 33913-8625 Ph: (239) 202-0932 |
| NPI Number | 1174029664 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Medicare PECOS PAC ID | 5092052779 |
|---|---|
| Medicare Enrollment ID | O20190204002308 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174029664 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | SP014025 (Florida) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Tracy M Dzugan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427474410 PECOS PAC ID: 0840417861 Enrollment ID: I20140814000741 |
| Provider Name | Nelson Monroy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396772497 PECOS PAC ID: 3678545506 Enrollment ID: I20160307002300 |
| Provider Name | James Knox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063679173 PECOS PAC ID: 1052671963 Enrollment ID: I20180213002612 |
| Provider Name | Gina Valo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205343746 PECOS PAC ID: 0345504940 Enrollment ID: I20180508000572 |
| Provider Name | Rosa Elvira Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912302829 PECOS PAC ID: 4486972270 Enrollment ID: I20180718003704 |
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