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General NPI Number Information
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NPI Number | 1003582610
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Entity Type | Organization
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Legal Business Name | SUNSHINE KIDS PEDIATRIC CARE LLC HOLLYWOOD THERAPY
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 6603 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4010
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Country | US
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Telephone | 954-881-8230
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Fax |
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Provider Business Mailing Address
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Address Line | 6603 TAFT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-4010
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Country | US
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Telephone | 954-881-8230
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID MAYMON
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Credential |
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Telephone | 954-881-8230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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