Healthcare Provider Details

I. General information

NPI: 1598451973
Provider Name (Legal Business Name): NEW SUNRISE MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 PLAZA REAL STE 275
BOCA RATON FL
33432-3999
US

IV. Provider business mailing address

1279 W PALMETTO PARK RD UNIT 273341
BOCA RATON FL
33427-0854
US

V. Phone/Fax

Practice location:
  • Phone: 561-944-0077
  • Fax:
Mailing address:
  • Phone: 561-944-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HELIA IBARRA-ALOS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 561-944-0077