Provider Demographics
NPI:1871046011
Name:SUNSHINE OCCUPATIONAL THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:SUNSHINE OCCUPATIONAL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:DIGIANO
Authorized Official - Last Name:IESLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, C/NDT
Authorized Official - Phone:352-843-0824
Mailing Address - Street 1:4510 NW 113TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1052
Mailing Address - Country:US
Mailing Address - Phone:352-843-0824
Mailing Address - Fax:
Practice Address - Street 1:4510 NW 113TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-1052
Practice Address - Country:US
Practice Address - Phone:352-843-0824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-24
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT15551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty