MEDICARE: SUNNY COAST THERAPEUTICS 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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	684827	FL

General Provider Information

NPI Number	:	1851378947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNY COAST THERAPEUTICS CORP

Provider Business Mailing Address
First Line	:	4872 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2102
Country	:	US
Telephone Number	:	305-444-4006
Fax Number	:	305-444-4007

Provider Business Practice Location Address
First Line	:	4872 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-2102
Country	:	US
Telephone Number	:	305-444-4006
Fax Number	:	305-444-4007

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ZEIDA CARIDAD RODRIGUEZ
Credential	:
Telephone Number	:	305-444-4006

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	03/03/2011

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