Healthcare Provider Details

I. General information

NPI: 1396554226
Provider Name (Legal Business Name): SUNSHINE KID THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 E THOMAS RD STE 100
PHOENIX AZ
85016-7858
US

IV. Provider business mailing address

19640 NW 58TH AVE
HIALEAH FL
33015-4908
US

V. Phone/Fax

Practice location:
  • Phone: 786-247-9161
  • Fax:
Mailing address:
  • Phone: 786-247-9161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HAROL SANTIAGO SANCHEZ DIAZ
Title or Position: OWNER
Credential:
Phone: 786-247-9161