Organization
SUNSHINE WELLNESS CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAUL OTONIEL GONZALEZ (OWNER)
(305) 218-9447
Entity
Organization
Contact information
Practice address
1200 NW 78TH AVE STE 215, DORAL, FL 33126-1890
(305) 465-0908
Mailing address
1200 NW 78TH AVE STE 215, DORAL, FL 33126-1890
(305) 465-0908
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12683
AHCA
FL
Enumeration date
07/28/2020
Last updated
01/20/2022
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