Provider Demographics
NPI:1043953516
Name:SUNSHINE SPECTRUM LLC
Entity Type:Organization
Organization Name:SUNSHINE SPECTRUM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:407-744-3657
Mailing Address - Street 1:8550 COUPLES ST
Mailing Address - Street 2:
Mailing Address - City:CHAMPIONS GT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-5503
Mailing Address - Country:US
Mailing Address - Phone:407-744-3657
Mailing Address - Fax:
Practice Address - Street 1:8550 COUPLES ST
Practice Address - Street 2:
Practice Address - City:CHAMPIONS GT
Practice Address - State:FL
Practice Address - Zip Code:33896-5503
Practice Address - Country:US
Practice Address - Phone:407-744-3657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty