Healthcare Provider Details

I. General information

NPI: 1376322131
Provider Name (Legal Business Name): SUNNY REIGN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 W CYPRESS CREEK RD STE 300
FORT LAUDERDALE FL
33309-1953
US

IV. Provider business mailing address

1451 W CYPRESS CREEK RD STE 300
FORT LAUDERDALE FL
33309-1953
US

V. Phone/Fax

Practice location:
  • Phone: 888-608-5556
  • Fax:
Mailing address:
  • Phone: 888-608-5556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DAPHNEY JOCELYN
Title or Position: OWNER
Credential: RN
Phone: 888-608-5556