Healthcare Provider Details

I. General information

NPI: 1437850914
Provider Name (Legal Business Name): SUNRISE BEHAVIOR THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8461 LAKE WORTH RD STE 436
LAKE WORTH FL
33467-2474
US

IV. Provider business mailing address

8461 LAKE WORTH RD STE 436
LAKE WORTH FL
33467-2474
US

V. Phone/Fax

Practice location:
  • Phone: 786-632-4688
  • Fax:
Mailing address:
  • Phone: 786-632-4688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MAYBEL LEZA
Title or Position: CEO
Credential:
Phone: 305-767-5631