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General NPI Number Information
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NPI Number | 1376435107
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Entity Type | Organization
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Legal Business Name | SUNRISE ABA OF FLORIDA, LLC
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 4034 S LOCKWOOD RIDGE RD
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City | SARASOTA
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State | FL
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Zip | 34231-7638
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Country | US
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Telephone | 628-250-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1530 MERIDIAN AVE
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City | SAN JOSE
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State | CA
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Zip | 95125-5350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRADY KEITH
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Credential |
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Telephone | 707-799-9527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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