Provider Demographics
NPI:1225568249
Name:SUNRISE MEDICAL AND REHAB LLC
Entity type:Organization
Organization Name:SUNRISE MEDICAL AND REHAB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-683-3855
Mailing Address - Street 1:10504 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5046
Mailing Address - Country:US
Mailing Address - Phone:352-683-3855
Mailing Address - Fax:352-683-4472
Practice Address - Street 1:1701 S TUTTLE AVE STE 1
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3111
Practice Address - Country:US
Practice Address - Phone:727-674-3290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNRISE MEDICAL AND REHAB LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty