Healthcare Provider Details

I. General information

NPI: 1811842867
Provider Name (Legal Business Name): SPHERE PEDIATRICS OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16690 COLLINS AVE STE 1102
SUNNY ISLES BEACH FL
33160-5687
US

IV. Provider business mailing address

16690 COLLINS AVE STE 1102
SUNNY ISLES BEACH FL
33160-5687
US

V. Phone/Fax

Practice location:
  • Phone: 480-310-1534
  • Fax: 480-314-9494
Mailing address:
  • Phone: 480-310-1534
  • Fax: 480-314-9494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SHAPIRO
Title or Position: CFO
Credential: CPA
Phone: 480-310-1534