Provider Demographics
NPI:1053137695
Name:SUNSHINE WELLNESS CLINIC INC
Entity type:Organization
Organization Name:SUNSHINE WELLNESS CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GOLDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:772-453-1072
Mailing Address - Street 1:2404 NE PALM AVE
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-5246
Mailing Address - Country:US
Mailing Address - Phone:772-453-1072
Mailing Address - Fax:772-510-4229
Practice Address - Street 1:1635 NE JENSEN BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-7229
Practice Address - Country:US
Practice Address - Phone:772-453-1072
Practice Address - Fax:772-510-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty