Organization Active NPI

Sunshine Family Medical Center, LLC

  • General Practice Physician
  • Fort Lauderdale, FL
National Provider Identifier
1306655840
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SUNSHINE FAMILY MEDICAL CENTER, LLC
Practice address
3333 W Commercial Blvd Ste 115B
Fort Lauderdale, FL 33309-3441
Phone
(954) 510-3638
Fax
(754) 263-5518
NPI assigned
Dec 30, 2024
Last updated
Mar 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kervie Dorval, APRNNPI 1306360839
Title
Manager
Phone
(954) 607-5540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

3333 W Commercial Blvd Ste 115B
Fort Lauderdale, FL 33309-3441

Mailing address

3333 W Commercial Blvd Ste 115B
Fort Lauderdale, FL 33309-3441
Phone (954) 607-5540

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250414000611 FL Part B Supplier - Clinic/Group Practice 1254855059 Receives reassigned benefits from 4 practitioners
Practice locations: Fort Lauderdale, FL

National Provider Directory

National Provider Directory

Locations

3333 W Commercial Blvd
Ste 115B
Fort Lauderdale, FL 33309
Phone (954) 510-3638

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1306655840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 W COMMERCIAL BLVD STE 115B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093441",
            "telephone_number": "954-607-5540",
            "fax_number": "754-263-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W COMMERCIAL BLVD STE 115B",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093441",
            "telephone_number": "954-510-3638",
            "fax_number": "754-263-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-30",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "DORVAL",
        "authorized_official_first_name": "KERVIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-607-5540",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.