Healthcare Provider Details

I. General information

NPI: 1295100980
Provider Name (Legal Business Name): SUNSHINE THERAPY GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2015
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ACCEPTANCE WAY
CLERMONT FL
34711-2788
US

IV. Provider business mailing address

1016 GOLDEN DAWN LOOP
MINNEOLA FL
34715-7680
US

V. Phone/Fax

Practice location:
  • Phone: 352-978-2882
  • Fax: 352-354-9863
Mailing address:
  • Phone: 352-978-2882
  • Fax: 352-354-9863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA9397
License Number StateFL

VIII. Authorized Official

Name: KRISTIN ANDERSON
Title or Position: OWNER
Credential:
Phone: 352-978-2882