Sun Miracle Wellness Center LLC
NPI 1164130613ActiveOrganization· Nurse Practitioner, Adult Health· Clearwater, FL
Nurse Practitioner, Adult Health in Clearwater, Florida, registered in NPPES in November 2022. The authorized official on file is Shanta K. Davis, AGNP-C, Owner.
Overview
| NPI | 1164130613 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 14, 2022 |
| Last updated in NPPES | Sep 25, 2023 |
| Certified by provider | Sep 25, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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