Provider Demographics
NPI:1841570975
Name:SUNSHINE
Entity Type:Organization
Organization Name:SUNSHINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RENFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:305-975-2234
Mailing Address - Street 1:2331 N STATE ROAD 7
Mailing Address - Street 2:124
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33313-3748
Mailing Address - Country:US
Mailing Address - Phone:975-533-2414
Mailing Address - Fax:
Practice Address - Street 1:2331 N STATE ROAD 7
Practice Address - Street 2:124
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3748
Practice Address - Country:US
Practice Address - Phone:975-533-2414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-20
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy