Provider Demographics
NPI:1851378947
Name:SUNNY COAST THERAPEUTICS CORP
Entity Type:Organization
Organization Name:SUNNY COAST THERAPEUTICS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZEIDA
Authorized Official - Middle Name:CARIDAD
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-444-4006
Mailing Address - Street 1:4872 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2102
Mailing Address - Country:US
Mailing Address - Phone:305-444-4006
Mailing Address - Fax:305-444-4007
Practice Address - Street 1:4872 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2102
Practice Address - Country:US
Practice Address - Phone:305-444-4006
Practice Address - Fax:305-444-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL684827261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684827Medicare Oscar/Certification