MEDICARE: SUNSTATE ORCHESTRAL PROGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1043011539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSTATE ORCHESTRAL PROGRAM

Provider Business Mailing Address
First Line	:	2310 W WATERS AVE STE D
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-2757
Country	:	US
Telephone Number	:	813-940-5414
Fax Number	:

Provider Business Practice Location Address
First Line	:	2707 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1836
Country	:	US
Telephone Number	:	813-940-5414
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. FRANCISCO JAVIER DIAZ
Credential	:
Telephone Number	:	786-631-6401

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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Directions to “SUNSTATE ORCHESTRAL PROGRAM ” Practice Location

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