Healthcare Provider Details

I. General information

NPI: 1093564155
Provider Name (Legal Business Name): HIGHLANDS SUNSHINE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 BOKEELIA WAY NE
LAKE PLACID FL
33852-7089
US

IV. Provider business mailing address

223 BOKEELIA WAY NE
LAKE PLACID FL
33852-7089
US

V. Phone/Fax

Practice location:
  • Phone: 863-441-3961
  • Fax:
Mailing address:
  • Phone: 863-441-3961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: SYLVIA BARAJAS
Title or Position: ADMINISTRATOR
Credential: AP
Phone: 863-441-3961