Healthcare Provider Details
I. General information
NPI: 1164339537
Provider Name (Legal Business Name): SUNNY ERA WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8512 GRAND ASPEN WAY
RIVERVIEW FL
33578-8410
US
IV. Provider business mailing address
8512 GRAND ASPEN WAY
RIVERVIEW FL
33578-8410
US
V. Phone/Fax
- Phone: 707-799-3549
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARIKA
KOESLING
Title or Position: OWNER
Credential: OTR/L
Phone: 707-799-3549