| Sunshine Behavioral Medicine Inc | |
|
5389 Cotton St Graceville FL 32440-1739 | |
| (850) 360-4147 | |
| (850) 360-4068 |
| Full Name | Sunshine Behavioral Medicine Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5389 Cotton St, Graceville, Florida |
| Authorized Official Name and Position | Kiumars E. Shams (PRESIDENT) |
| Authorized Official Contact | 8503604147 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunshine Behavioral Medicine Inc Po Box 186 Graceville FL 32440-0186 Ph: (850) 360-4147 | Sunshine Behavioral Medicine Inc 5389 Cotton St Graceville FL 32440-1739 Ph: (850) 360-4147 |
| NPI Number | 1598266850 |
|---|---|
| Provider Enumeration Date | 02/22/2018 |
| Last Update Date | 01/06/2022 |
| Certification Date | 01/06/2022 |
| Medicare PECOS PAC ID | 9931520608 |
|---|---|
| Medicare Enrollment ID | O20200604001501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598266850 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Kiumars Shams |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1386780302 PECOS PAC ID: 8224001219 Enrollment ID: I20040818001136 |
| Provider Name | Nicole Mosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780111849 PECOS PAC ID: 6103247879 Enrollment ID: I20200612000291 |
Solutions Nu Counseling & Consulting Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1027 7th Ave, Graceville, FL 32440 Phone: 850-447-3647 |