Healthcare Provider Details

I. General information

NPI: 1740936137
Provider Name (Legal Business Name): SUNSHINE THERAPEUTIC SERVICES OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 MEADOWBROOK DR
WINTER SPRINGS FL
32708-2117
US

IV. Provider business mailing address

6451 COW PEN RD APT K209
MIAMI LAKES FL
33014-6624
US

V. Phone/Fax

Practice location:
  • Phone: 786-246-3830
  • Fax:
Mailing address:
  • Phone: 786-246-3830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIELA FERNANDEZ
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 786-246-3830