Healthcare Provider Details

I. General information

NPI: 1679478861
Provider Name (Legal Business Name): SUNSET PROFESSIONAL CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 SW 72ND ST STE 142
MIAMI FL
33173-3038
US

IV. Provider business mailing address

10300 SW 72ND ST STE 142
MIAMI FL
33173-3038
US

V. Phone/Fax

Practice location:
  • Phone: 786-870-5243
  • Fax: 786-870-5495
Mailing address:
  • Phone: 786-870-5243
  • Fax: 786-870-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ANDRES FELIPE PACHECO
Title or Position: OWNER/CEO
Credential:
Phone: 786-447-1028