Provider Demographics
NPI:1386239309
Name:SIDRON-HORD, SUNAY
Entity type:Individual
Prefix:
First Name:SUNAY
Middle Name:
Last Name:SIDRON-HORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 45TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-1920
Mailing Address - Country:US
Mailing Address - Phone:954-226-3690
Mailing Address - Fax:
Practice Address - Street 1:14411 COMMERCE WAY STE 350
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-1600
Practice Address - Country:US
Practice Address - Phone:305-530-8119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health