Provider Demographics
NPI:1114279577
Name:SUNSHINE PHYSICAL THERAPY & REHAB INC
Entity Type:Organization
Organization Name:SUNSHINE PHYSICAL THERAPY & REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HAFIZ
Authorized Official - Middle Name:S
Authorized Official - Last Name:TAHIR
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:313-757-7234
Mailing Address - Street 1:5461 SCHAEFER RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3222
Mailing Address - Country:US
Mailing Address - Phone:313-757-7234
Mailing Address - Fax:313-757-7236
Practice Address - Street 1:5461 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3222
Practice Address - Country:US
Practice Address - Phone:313-757-7234
Practice Address - Fax:313-757-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicare PIN