Healthcare Provider Details

I. General information

NPI: 1730887548
Provider Name (Legal Business Name): SUNSHINE AUTISM CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 01/17/2024
Certification Date: 01/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26844 TANIC DR
WESLEY CHAPEL FL
33544-4616
US

IV. Provider business mailing address

15310 AMBERLY DR STE 175
TAMPA FL
33647-1640
US

V. Phone/Fax

Practice location:
  • Phone: 813-389-9831
  • Fax:
Mailing address:
  • Phone: 800-434-2582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM LUCAS
Title or Position: OWNER
Credential:
Phone: 800-434-2582