Healthcare Provider Details

I. General information

NPI: 1063316834
Provider Name (Legal Business Name): SUNBURST REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 ARIANA AVE
AUBURNDALE FL
33823-4139
US

IV. Provider business mailing address

505 ARIANA AVE
AUBURNDALE FL
33823-4139
US

V. Phone/Fax

Practice location:
  • Phone: 863-226-0358
  • Fax:
Mailing address:
  • Phone: 863-226-0358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SAVITRI JOHNSON
Title or Position: ADMINISTRATIVE ASSISTANT/AR
Credential:
Phone: 863-226-0358