Provider Demographics
NPI:1336584069
Name:SUNSHINE PHARMACY AT GULFSHORE
Entity type:Organization
Organization Name:SUNSHINE PHARMACY AT GULFSHORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:REQUENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-775-6800
Mailing Address - Street 1:5480 RATTLESNAKE HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-7454
Mailing Address - Country:US
Mailing Address - Phone:239-775-6800
Mailing Address - Fax:239-775-7377
Practice Address - Street 1:5480 RATTLESNAKE HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-7454
Practice Address - Country:US
Practice Address - Phone:239-775-6800
Practice Address - Fax:239-775-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy