MEDICARE: SUNRISE ABA SOLUTIONS, CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528931151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE ABA SOLUTIONS, CORP

Provider Business Mailing Address
First Line	:	6415 SW 129TH PL APT 2404
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-5387
Country	:	US
Telephone Number	:	786-479-4183
Fax Number	:	786-479-4183

Provider Business Practice Location Address
First Line	:	6415 SW 129TH PL APT 2404
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-5387
Country	:	US
Telephone Number	:	786-479-4183
Fax Number	:	786-479-4183

Authorized Official
Title or Position	:	OWNER
Name	:	KENIA DEL SOL AMADOR
Credential	:	BCBA
Telephone Number	:	786-479-4183

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	09/29/2025

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