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General NPI Number Information
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NPI Number | 1023053394
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Entity Type | Organization
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Legal Business Name | SUNSHINE THERAPY CENTER, INC.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 6320 SAINT AUGUSTINE RD UNIT 1
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2800
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Country | US
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Telephone | 904-448-5075
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Fax | 904-636-7595
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Provider Business Mailing Address
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Address Line | 6320 SAINT AUGUSTINE RD UNIT 1
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2800
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Country | US
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Telephone | 904-448-5075
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Fax | 904-636-7595
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Authorized Official
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Title or Position | PRESIDENT
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Name | THADDEUS THOMPSON
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Credential | PT
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Telephone | 904-448-5075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State | FL
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