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NPI Code Detail

MEDICARE: SUNSHINE REHAB, LLC

MEDICARE: SUNSHINE REHAB, LLC
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
1235Z00000XSpeech-Language Pathologist15637TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115637OTHERTXSTATE OF TEXAS SPEECH BOARD NUMBER FOR CLINICAL MANAGER
2NONEOTHERTXWE CURRENTLY ARE A NEW PRACTICE PENDING CMS PAPERWORK

General Provider Information

NPI Number : 1083938187
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSHINE REHAB, LLC
Provider Business Mailing Address
First Line : 875 S SAM HOUSTON BLVD STE D
Second Line :
City : SAN BENITO
State : TX
Zip : 78586-3062
Country : US
Telephone Number : 956-281-1274
Fax Number :
Provider Business Practice Location Address
First Line : 875 S SAM HOUSTON BLVD STE D
Second Line :
City : SAN BENITO
State : TX
Zip : 78586-3062
Country : US
Telephone Number : 956-281-1274
Fax Number :
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MRS. RACHEL CALDERON
Credential :
Telephone Number : 956-281-1274
Provider Enumeration Date : 03/17/2010
Last Update Date : 03/17/2010

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Directions to “SUNSHINE REHAB, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.