Healthcare Provider Details

I. General information

NPI: 1538596713
Provider Name (Legal Business Name): SUNRISE RESEARCH INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 SW 12TH AVE STE 302
MIAMI FL
33130-2433
US

IV. Provider business mailing address

434 SW 12TH AVE STE 302
MIAMI FL
33130-2433
US

V. Phone/Fax

Practice location:
  • Phone: 786-409-6849
  • Fax: 786-409-6872
Mailing address:
  • Phone: 786-409-6849
  • Fax: 786-409-6872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: YULIEN DIAZ
Title or Position: OWNER
Credential:
Phone: 786-409-6849