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General NPI Number Information
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NPI Number | 1952686636
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Entity Type | Organization
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Legal Business Name | SUN STATE HEALTH INC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 255 E DANIA BEACH BLVD SUITE 228
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City | DANIA BEACH
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State | FL
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Zip | 33004-3083
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Country | US
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Telephone | 855-411-4774
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Fax | 877-234-5698
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Provider Business Mailing Address
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Address Line | 255 E DANIA BEACH BLVD SUITE 228
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City | DANIA BEACH
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State | FL
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Zip | 33004-3083
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Country | US
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Telephone | 855-411-4774
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Fax | 877-234-5698
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MR. JOSE R ROJO
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Credential | LMHC
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Telephone | 305-332-0221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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